부산대학교 도서관

We established a clinical network system for diabetic patients who do not have unstable complications and investigated the current situation and problems in the functioning of the network for four years. Seventy-eight diabetic patients who were referred to general practitioners underwent clinical examinations every six months and annual detailed examinations for diabetic complications at our hospital, independent of their monthly visits to the clinics. Patient satisfaction was investigated six months after the referral. The clinical status and progression of complications was followed up for four years. Eighty percent of the patients reported being satisfied with the system. However, some patients showed anxiety or dissatisfaction with the changes in the testing methods and clinical decisions. The four-year follow-up could be completed in 69 patients (clinical network group). The HbA1c in the 52 patients who continued to participate in the clinical network for four years increased significantly after one year (p<0.0001), and was higher than that in the patients (control group) who continued to attend our hospital after four years (p=0.047). Retinopathy and nephropathy developed at a similar frequency in the clinical network group and the control group. When a clinical network is organiced for patients with diabetes, it is also necessary to include systems for the rapid treatment of worsening glycemic control and periodic examinations of diabetic complications.