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Objective - To describe the use and level of HbA1c in a large unselected Type 2 diabetic population in Denmark. In addition, to describe the characteristics of the patients and the general practitioners in relation to the monitoring of HbA1c. Design - Data were collected from public data files for the period January 1993 to December 1997. Setting - The County of Vejle with a background population of 342597 citizens, 303 250 of whom were listed with participating general practitioners. Patients - The Type 2 diabetic population alive and resident in the county on 1 January 1997. Results - In a population of 4438 Type 2 diabetics, 73% had a minimum of one annual HbA1c measurement in 1997. No HbA1c measurement was associated with a long history of diabetes, diet treatment or old age. Poor glycaemic regulation was found in 65% of the Type 2 diabetics in 1997. Poor glycaemic regulation was associated with tablet or insulin treatment, age under 70 years and long history of diabetes. The interpractice variation was huge. Conclusion - The quality of HbA1c monitoring of Type 2 diabetics needs to be improved. Possibilities for improvement seem to be present. [ABSTRACT FROM AUTHOR]

Editorial. Focuses on characteristics of complex adaptive system (CAS) in the general practice of medicine with reference to the March 2003 issue of the 'Scandinavian Journal of Primary Health Care.' Changes in CAS; Ways to improve clinical practice; Need for understanding the dynamics of CAS.