Sharing and delegation are not panaceas for improved diabetes care

Background: Type 2 diabetes is an important, chronic condition notorious for its costly and disabling complications. Nowadays enhanced cooperation is expected to improve the quality of diabetes care and reduce the risks for chronically ill patients. It is, however, questionable whether this assumption is evidence-based. Methods Using a structured literature search, we selected systematic reviews, RCTs and other effect evaluations regarding the sharing and assignment of diabetes care. Results Finally we included 22 studies in this review. The process of care improved in all studies investigating this quality aspect. HbA1c improved in seven reviews and in five other studies. All included reviews and four RCTs were unable to demonstrate a positive effect on blood pressure. Total cholesterol improved in two reviews and five other studies. Conclusion The sharing and assignment of diabetes care leads to significant reduction in HbA1c and improves the process of care. However this improvement has not as yet led to better cardiovascular risk managemen