Experts' opinions on the profile of optimal care for patients with diabetes mellitus type 2 in the Netherlands

Background: The St. Vincent Declaration has resulted in discussions and initiatives on optimal diabetes care during recent years. Both are based on two sources of knowledge: evidence and experience. We wanted to reveal the experience based knowledge in the Netherlands to identify essential elements or prerequisites for high quality type 2 diabetes care. Methods: A group of 56 experts on diabetes care were invited to fill in a questionnaire. This included a ranking of 18 elements on the organization of diabetes care and 9 on patient education. Results: The response rate was 87.5%. With regard to the organization of care 'active patient participation', 'protocolized care' and 'patient education' were evaluated as the most important. The integration in daily diabetes care was seen as the most important aspect of patient education. Optimal diabetes patient education would include five sessions (range: 1-10) of 1 h (range: 0.25-3) with active follow-up. The most appropriate disciplines for patient education are the diabetes nurse (chosen by 93% of the experts) and the dietician (77%). Conclusions: Optimal care for diabetes mellitus type 2 consists of structured care with integrated patient education. The majority of the experts indicated that this is not optimally organized within the Netherlands. (C) 2001 Elsevier Science B.V. All rights reserved.