Diabetes is a chronic condition that affects millions of people worldwide and can lead to serious complications such as cardiovascular disease, kidney failure, blindness, and amputation. However, evidence shows that optimal management of diabetes can prevent or delay these complications and improve the quality of life of patients. Primary care is the first point of contact for most patients with diabetes and plays a crucial role in providing comprehensive and coordinated care. Therefore, improving diabetes management in primary care is a key priority for health systems.
Several interventions have been proposed to enhance the performance of health professionals and the organization of care in primary care settings. A systematic review by Renders et al. (2001) found that multifaceted professional interventions, such as education, feedback, reminders, and audit, can improve the process of care for patients with diabetes, such as adherence to guidelines, screening for complications, and prescribing of medications. Organizational interventions that facilitate regular prompted recall and review of patients, such as central computerized tracking systems or nurses who regularly contact the patient, can also improve diabetes management. Moreover, complex interventions that combine professional and organizational strategies with patient education and empowerment can lead to improvements in both the process and outcomes of care, such as glycemic control, blood pressure, cholesterol, and quality of life.
These interventions require a collaborative approach among health professionals, patients, and community resources. Primary care providers need to be aware of the evidence-based treatments for diabetes and how to effectively communicate them to patients. They also need to have access to programs and resources that can support them in delivering high-quality care, such as diabetes prevention and management programs, self-management education, peer support groups, and referral networks . By implementing these interventions in primary care settings, it is possible to achieve better outcomes for patients with diabetes and reduce the burden of this condition on individuals and society.
References
: Shubrook JH. Diabetes Prevention and Management in the Primary Care Setting. Diabetes Care 2019;24(10):1821-1833. https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/diabetes-prevention-and-management-primary-care-setting
: Renders CM, Valk GD, Griffin SJ, Wagner EH, Eijk JT van, Assendelft WJJ. Interventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings: A systematic review. Diabetes Care 2001;24(10):1821-1833. https://diabetesjournals.org/care/article/24/10/1821/20597/Interventions-to-Improve-the-Management-of
: Renders CM et al. Diabetes management in primary care, outpatient and community settings can be improved by interventions targeting health professionals and organisational interventions that increase continuity of care. Cochrane Database Syst Rev 2000;(4):CD001481. https://www.cochrane.org/CD001481/EPOC_diabetes-management-in-primary-care-outpatient-and-community-settings-can-be-improved-by-interventions-targeting-health-professionals-and-organisational-interventions-that-increase-continuity-of-care
: Ely EK et al. Preventing Diabetes in Primary Care: Providers’ Perspectives About Diagnosing and Treating Prediabetes. Clin Diabetes 2018;36(1):59-66. https://diabetesjournals.org/clinical/article/36/1/59/31793/Preventing-Diabetes-in-Primary-Care-Providers
