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An accurate and valid district diabetes register is needed to identify people with diabetes. Quality assurance of such a register is vital to deliver high-standard patient care. We report the findings of a methodical process of validation of the Wolverhampton District Diabetes Register (WDDR) post extraction of information from general practitioner (GP) databases, and propose an algorithm for resolving any disparity between the two data registers.Historic diabetes register data were matched with GP databases; discrepancies were checked with GP practices and updated on the WDDR. Unidentifiable people were subject to demographic checks with the Demographic Batch Service (DBS). DBS information was used to identify patients by contacting them directly or by contacting their GP practices. Diagnostic discrepancies were corrected by biochemical checks or identifying coding errors in the GP database.Of 2565 people unmatched with GP databases, 2380 had an identifiable GP. After checking with GP practices, 1244 (48.5%) were identified to have coding errors, 61 (2.4%) deceased and 333 (13%) with diagnostic inaccuracy of diabetes. A total of 927 (36%) patients with no identifiable GP were subject to demographic checks. Of these, 237 (9.2%) were found to be in the area and registered with another GP, 220 (8.6%) had no identifiable GP, 422 (16.4%) patients were not in the area, and 48 (1.9%) were deceased.To maintain a valid district diabetes register (WDDR), a rolling mechanism of demographic cross checks is required at regular intervals to reduce the number of discrepancies and increase the accuracy of such a register. Copyright © 2013 John Wiley & Sons.