Cases of T2DM from the RSNC reported in the NPD were extracted based on an ICD-10 code assessment of E11 (non-insulin-dependant diabetes mellitus). One auditor reviewed 30 files and tabulated audit scores. The Research Ethics Board of CCNM provided ethical oversight of this project. The American Diabetes Association 2010 standards of medical care in diabetes were used as guidelines for the audit. Multiple categories in diagnosis, physical exam, labs, and management were graded on a 0-2 scale. The Measure Yourself Medical Outcome Profile (MYMOP) is used by the RSNC as a universal outcome measure of effectiveness of individualized patient-defined symptoms and was incorporated into the audit and reporting of results. The average audit score is 55.5/90. The most common interventions being used are diet and aerobic exercise, followed by supplements (omega-3 fatty acids) and botanicals. Preliminary data suggests that the standards of care for T2DM are not followed stringently, particularly with regards to complete physical exams, appropriate referrals, and goal-setting. Education and creation of a naturopathic standard of care may improve audit performance and patient outcomes.
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Habib et al. (2012) studied this question.
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