23 Apr, 13 | by Dr Dean Jenkins
Unfortunately it seems that in the real world primary care can only stabilise weight and HbA1c in people with Type 2 Diabetes. A study of electronic records in primary care in the Netherlands has shown that the effect of lifestyle interventions was not as great as that seen in published research.
“Despite effective lifestyle interventions in controlled trial settings, we found that real-world primary care is only able to stabilize weight and HbA1c in patients with T2DM over time. Medical registration can be used to monitor the actual effectiveness of interventions in primary care.” 
The authors felt that more future research (of effectiveness) should take place in real-world primary care settings and especially those that have electronic records. This would better reflect the feasibility of translating this research into practice.
Another finding from the study was that the authors felt most of the variability of outcomes was explained by differences between patients rather than healthcare staff. This has implications for correct interpretation of variability in apparent performance.
1. Linmans JJ, Viechtbauer W, Koppenaal T, Spigt M, Knottnerus JA. Using electronic medical records analysis to investigate the effectiveness of lifestyle programs in real-world primary care is challenging: a case study in diabetes mellitus. J Clin Epidemiol 2012 Jul;65(7):785–792. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22560776