An assessment of the big gest problem in diabetes care from the viewpoint of 115 health care profes sionals and 428 diabetic patients was obtained. There was substantial agreement by health pro fessionals and patients alike that diet and diet- related issues constituted the most difficult problem faced by persons with diabetes and by health professionals caring for those persons. These find ings may be important in organizing diabetes patient education and in the selection of research efforts within the overall field of diabetes.

This paper describes the diabetes care and education provided to 290 diabetic patients by 47 nurses working in primary care physicians' offices in two Michigan communities. The study utilized data from questionnaires and logbooks of patient contacts kept by the 47 nurses. The study demonstrated that nurses could play an important role in caring for persons with diabetes, but indicated that office nurses were constrained from delivering optimal care by lack of time, resources, and diabetes-related continuing education. Since the majority of patients with diabetes receive their ongoing diabetes care and education in primary care physicians' offices, and since nurses, as a profession, can and should play a major role in the overall care of these patients, a national effort to improve the quality of patient education provided by this very large group ofhealth professionals is indicated. The diabetes patient education provided by office nurses should supplement, but not replace, the comprehensive diabetes patient education provided by programs that meet national standards.The majority of diabetes treatment in the United States is delivered in physicians' offices. In 1980, there were an estimated 13-16 million visits to physicians' offices for diabetes care with another 3 million physician contacts made by phone or through visits to hospital clinics or emergency rooms. Nationally, the average number of visits to physician offices is three per year per patient with diabetes. I In 1985, extrapolation of the data from the National Ambulatory Medical Care Survey showed that 3.3% (or 21.3 million visits) of all visits to office-based physicians (n = 288,200) were related to diabetes.2* Data3 gathered in a random sample of Michigan communities showed that patients with diabetes visited their physicians' offices an average of four times a year and received much of their ongoing care and education from nurses in the physician's office. These data suggest that nurses working in physicians' offices can play a major role in providing diabetes care and education to a large number of patients with diabetes.Although the majority of patients receive their diabetes care and education in physicians' offices, little data exist describing the characteristics of the nurses working in these settings and their role in providing diabetes care and patient education. A study4 by the University of Michigan Diabetes Research and Training Center (MDRTC) indicated that the diabetes patient education occurring in physicians' offices was much less structured and less formal than the education occurring in hospitals in the same communities. In addition, this study showed that in physicians' offices structured needs assessments were seldom used and/or recorded. This study, however, did not provide information about the types or amount of diabetes care and education provided by nurses in the office setting. If efforts are to be made to improve the quality of diabetes care and patient education delivered by

The task of reviewing and critiquing the hundreds of audiovisual programs available for diabetes education is an exceedingly time consuming and tedious activity. To assist the many users of educational audiovisual materials the Outreach Core of the Michigan Diabetes Research and Training Center undertook the review and critique of these programs. Based on specified selection and review cri teria, 35 programs have been chosen for inclusion in a booklet entitled "Recommended Audiovisual Re sources for Diabetes Education. " This booklet is available to any diabetes educator upon request.