Effective diabetes care requires a functional information system that can be utilised in different healthcare settings. Such systems will enable focused individual patient care, and provide an opportunity to identify and meet needs within area health economies, address issues of quality of healthcare, and support research, education and audit. At present over 25% of secondary care services in the United Kingdom do not have any computerised diabetes database. This severely impairs efforts to identify the case load and provide integrated diabetes care across primary and secondary care, and to offer full coverage of screening schemes to detect diabetic retinopathy. The data included in any such system need to be structured and operate at different levels of complexity and detail. It should be feasible to enter and access data whilst maintaining patient confidentiality. Funding issues need to be addressed in the establishment and maintenance of databases if the ambitions of the National Service Framework (NSF) for Diabetes are to be realised.
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