The lancet. Diabetes & endocrinology · 2026
Diabetes and the role of primary care: a global perspective.
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Kar Partha, Sathanapally Harini, Aschner Pablo, Baatiema Leonard, Cheng Alice, Gupta Yashdeep, Hambling Clare, Ma Ronald, Seidu Samuel, Khunti Kamlesh
Аннотация
The global prevalence of diabetes is rising rapidly, with the steepest increases and greatest unmet need occurring in low-income and middle-income countries. Despite strong evidence that early detection and continuous management reduce morbidity and mortality, many health systems face persistent gaps in diagnosis, treatment, and follow-up of people with diabetes. Primary care is the most accessible platform for screening and care coordination, and is central to addressing these challenges. Primary care-led models, including nurse-led and pharmacist-led interventions, integrated multidisciplinary teams, and digitally enabled care pathways, have shown improvements in glycaemic control, cardiometabolic outcomes, and health-care use in people with type 2 diabetes across primary care and community settings. Global initiatives, such as the WHO Global Diabetes Compact and UN non-communicable disease targets, emphasise strengthening primary care to deliver equitable, cost-effective diabetes care at scale. Future priorities include workforce development, addressing health inequalities, scalable implementation strategies, and robust evaluation of long-term outcomes to enable person-centred type 2 diabetes care across diverse health-system contexts.