BACKGROUND AND OBJECTIVES: Diabetes is a chronic, potentially disabling and often fatal disease. The International Diabetes Federation estimates that more than 245 million people around the world are living with diabetes. Around 3.2 million deaths are attributable to complication of diabetes every year; six deaths every minute. Pakistan is in the top ten countries in the number of sufferers from diabetes. This disease requires continuing proper medical care and patient self-management education to prevent complications Current study aims to observe the current standard in the management of diabetic at a private tertiary care hospital in Karachi, Pakistan. METHODS: A retrospective health record review was done at a private tertiary care hospital at Karachi, Pakistan. Health records for all the persons with diabetes, who visited general physician or family physician during the months of April and May 2007, were included in this study. Two indicators including foot examination and advice for HbA1C diagnostic test for this cross sectional survey were identified. Data were analyzed using descriptive statistics. RESULTS: Total 350 health records were reviewed and of these, 40% were males and 60 females. Majority of the diabetics (80%) were over the age of 50 years. We found that only 40% of the patients were physically checked for foot examination and advised for HbA1C lab investigation by their general physician or family physician. About 44% were not either checked for foot examination or advised for HbA1C. CONCLUSIONS: Diabetes is a devastating chronic disease and can result in death very early if not managed properly. Current study suggest that adherence to the current screening guidelines was inadequate in this practice setting. Adherence to current diabetes management guidelines and diabetes care quality improvement initiatives can result in significant improvements in the provision and documentation of diabetes care.