[Management of diabetes in Austria 5 years after the St. Vincent Declaration]

In 1989 representatives of all European governments agreed on the "St. Vincent Declaration". In this statement of intent and recommendations all governments, including that of Austria, pledged to implement policies on preventive measures geared to reduce morbidity and mortality of all diabetic patients in Europe. Structured patient education has been shown to improve the overall quality of care in Type 1 diabetic patients. Reduction of acute metabolic disturbances after participation in the patient education programme reduces hospitalizations and allows significant savings in health care costs, which can help to make safe and effective therapy available to all patients with Type 1 diabetes without additional costs. A teaching and treatment programme for Type 2 diabetics by general practitioners has proven to be effective, feasible and inexpensive. Nationwide implementation of such an evaluated patient education programme shifts diabetes care to "primary health care" level, and increases long-term quality of diabetes care without generating new expenses. Patient education is considered not only the basis for successful management of diabetes, but also, as laid down in the St. Vincent Declaration, a basic human right of all patients, which still needs to be put into practice.