Research

The GIANT study (General Practice Implementation in Asia of Normoglycaemic Targets) was a randomised controlled multinational study designed to investigate whether education of local general practitioners about the International Diabetes Federation Western Pacific Region diabetes management guidelines led to improved glucose control in their patients. The study enrolled 100 GPs in 10 countries, with each GP enrolling four patients with type 2 diabetes (400 patients in total). Half of the GPs received training about the guidelines and half did not. Over a 12-month period, the study determined that there was no statistically significant difference in glucose control, blood pressure or lipids between the two groups. Substantial numbers of patients had poor glucose control throughout the study, despite the education on guidelines. Barriers to good care at both the patient level and GP level appeared to explain some of the gap between guidelines and actual practice. The outcome of this study highlights the need to find more effective ways of motivating GPs to follow guidelines. The study was funded by GlaxoSmithKline.