The significance of diabetes and disability: Referrals made to a disability service

Abstract

Diabetes mellitus is an important cause of disability even after correction for complications. It has been suggested that diabetes may be underestimated in referrals to rehabilitation services. We tested this by assessing how often patients with diabetes had this diagnosis mentioned when referred to a wheelchair clinic. Two hundred consecutive referrals to a wheelchair service were assessed to ascertain whether diabetes was mentioned in the referral letter compared to how many actually had a diagnosis of diabetes. This was then compared to other medical conditions to assess whether diabetes was being under-mentioned in referrals. Only 7/29 (24.1%) patients with diabetes in the cohort had diabetes mentioned in their referral. By comparison, 34/42 (81%) of those with stroke/heart failure/chronic obstructive pulmonary disease were mentioned (χ2=22.69, df=1, p<0.001) There was no difference between those with diabetes mentioned or not mentioned in terms of age, gender, type of diabetes, HbA1c or complication rate. We conclude that diabetes is under-mentioned in referrals to a rehabilitation service. It may be the case that health services are yet to appreciate the significance of diabetes as a cause of disability compared to other major conditions that cause disability. There seems to be a need to create an awareness of the importance of diabetes in disability. Copyright © 2006 John Wiley & Sons, Ltd.