It is true that a primary goal of diabetes early diagnosis and treatment is quality of life (QoL). The term QoL is still confusing but it is agreed that it composes of four components: The physical component, mental, cogitative component, psychological and social component. Many articles have been written addressing those four components. During the last five years 15500 articles and reviews have been written addressing diabetes and coronary arterial disease, 16100 addressing diabetes and renal function, 28900 addressing diabetes and retinopathy, 16800 addressing diabetic foot ulcers and other 26300 addressing diabetic neuropathy. Moreover 17200 articles are dealing with diabetic sexual dysfunction, 24500 with the correlation of diabetes and depression 17500 about diabetes and dementia, only 1 about diabetes and family functioning and 1950000 about diabetes and QoL, indicating the worldwide interest. In order to confront this metabolic anomaly and its consequences, researchers developed numerous generic and disease specific psychometric tools. With the aid of those psychometric tools the scientific community has started to realize the gruesome effect of diabetes on patients' lives. Diabetic's QoL becomes worse when complications start to develop or comorbidities coexist. Dominant amongst complications, in health-related quality of life (HRQoL) lowering, but not related to risk factors (genetic, the weight of birth, or others) is coronary arterial disease followed by renal failure, blindness, and the combination of micro- and macro-vascular complications and in some studies by sexual dysfunction. Moreover many are the comorbidities which deteriorate further the effect of diabetes in a patient life. Among them obesity, hypertension, dyslipidemia, depression, arthritis are the most common. Most intriguing field for research is the interaction of diabetes and depression and in some cases the progression to dementia. Many aspects and combinations of actions are under researchers' microscope regarding the improvement of HRQoL scores. Until now, the studies performed, have demonstrated little to moderate benefit. More of them are needed to draw safe conclusions on the topic of the best combination of actions to optimize the HRQoL scores.

This article focuses on approaches within clinical practice that seek to actively involve patients with long-term conditions (LTCs) and how professionals may understand and implement them. Personalized care planning is one such approach, but its current lack of conceptual clarity might have impeded its widespread implementation to date. A variety of overlapping concepts coexist in the literature, which have the potential to impair both clinical and research agendas. The aim of this article is therefore to explore the meaning of the concept of care planning in relation to other overlapping concepts and how this translates into clinical practice implementation.

Searches were conducted in the Cochrane database for systematic reviews, CINHAL and MEDLINE. A staged approach to conducting the concept mapping was undertaken, by (i) an examination of the literature on care planning in LTCs; (ii) identification of related terms; (iii) locating reviews of those terms. Retrieved articles were subjected to a content analysis, which formed the basis of our concept maps. (iv) We then appraised these against knowledge and experience of the implementation of care planning in clinical practice.

Thirteen articles were retrieved, in which the core importance of patient-centredness, shared decision making and self-management was highlighted. Literature searches on these terms retrieved a further 24 articles. Our concept mapping exercise shows that whilst there are common themes across the concepts, the differences between them reflect the context and intended outcomes within clinical practice. We argue that this clarification exercise will allow for further development of both research and clinical implementation agendas.

Previous studies have shown inconsistent results with regard to whether or not self-monitoring of blood glucose (SMBG) is related to better glycaemic control in type 2 diabetes. The aim of this study was to explore the use of SMBG and its association with glycaemic control in patients with type 2 diabetes in primary care.

A cross-sectional observational study was conducted in 2003 at 18 primary health care centres in Sweden, in which all known patients with diabetes were surveyed. The study included 6495 patients with type 2 diabetes. A sample of 896 patients was selected for further exploration of data from medical records. A telephone interview was performed with all patients in this group using SMBG (533 patients).

There were no differences in HbA1c levels between users (6.9%) and non-users (6.8%) of SMBG in patients treated with insulin or in patients treated with oral agents (6.3% in both groups). In patients treated with diet only, users of SMBG had higher levels of HbA1c compared with non-users (5.5% vs. 5.4%, p =0.002). Comparing medical records between users and non-users of SMBG showed no differences in diabetes-related complications in any treatment category group.

The use of SMBG was not associated with improved glycaemic control in any therapy category of patients with type 2 diabetes in primary care. The absence of difference in glycaemic control between users and non-users of SMBG could not be explained by differences in comorbidity between users and non-users of SMBG.

To give an overview of the concepts used to describe and evaluate the outcome of general practice consultations.

A literature study was undertaken. Among 101 articles relevant to the subject 35 were chosen to illustrate the concepts found.

The following concepts were found: disease control, patient compliance, efficacy, symptom relief, enablement, general health, and patient satisfaction. The first three concepts encourage objective measurement while the following four concern the patient's subjective assessment. Methods naturally linked to the respective concepts are briefly described.

The concepts reflect very diverse aspects of general practice. Some of the concepts come from other domains of research, while others have been developed within general practice. Disease is not exclusively in focus. The experience, competence, and life situation of the patient are as well dealt with as they should be in accordance with a patient-centred profession. However, the concepts spring from the researchers' ideas about what is important to patients. The patients' priorities were not sought.

To determine inner city American Indians' perceptions of diabetes; find out how they manage their disease; and identify what health care improvements may be necessary for this population.

Eight focus group discussions conducted with diabetic inner city American Indian adults.

Focus group discussions led by moderator using open-ended questions with prompts.

Eligibility criteria include age (> or = 18 years), a self-reported diagnosis of diabetes, and self-identification as inner city American Indian. Participants were screened by telephone to ensure all criteria were met. Forty inner city American Indian men and women participated in 8 focus groups.

American Indians' perception of diabetes, its treatment, and how they manage the disease.

Focus group discussions were tape recorded and transcribed verbatim. Transcripts were analyzed by coding responses and identifying common themes according to content analysis procedures. Quantitative data from self-administered demographic forms were analyzed.

Participants could verbalize information regarding treatment and management of diabetes, but few could apply this information to their own lives. Some participants were homeless or without insurance, which makes successful disease management difficult. Perceptions of the health care system varied; a majority felt the system was meeting their needs, whereas others said it was not adequate.

The study identified the need for health care workers to develop a better understanding of how this population lives; doing so could improve patient compliance to treatment. The results may provide direction for the development of culturally specific diabetes education appropriate for low-income patients focusing on the diabetic diet and exercise, and suggesting ways that the patient can move from knowing the information to implementing behavior change.