The Kelowna Diabetes Program: Bridging the Gap Between Testing Guidelines and Reality

A laboratory-based program is described that assists physicians and their patients with diabetes in meeting Canadian Diabetes Association (CDA) practice recommendations for laboratory testing. The program also supports self-management of diabetes by providing laboratory results directly to patients as well as their physicians.

The program is described in detail, and data from an uncontrolled case series are reported.

After 5.5 years of operation, 69% of people presumed to have diabetes in the study area of the Central Okanagan, British Columbia (BC), have been registered in the Kelowna Diabetes Program, and 98% of family physicians participate. Program participants are more likely to have laboratory testing at or near CDA-recommended frequencies than both program non-participants and all BC residents with diabetes. Program participants are also more likely to meet CDA targets for glycated hemoglobin, low-density-lipoprotein cholesterol and systolic blood pressure than program non-participants.

A laboratory-based program that provides people with diabetes with their own test results and supports a schedule for laboratory testing can lead to improvements in testing frequencies and appears to promote improved metabolic control as measured by the proportion of test results meeting CDA targets. An independent study by the BC Provincial Health Services Authority in conjunction with the BC Ministry of Health is now underway and will compare clinical outcomes for people with diabetes in this program with those for people with diabetes from a similar community in which there is no centrally organized support for diabetes testing.