Diabetes and the role of primary care: a global perspective.

Abstract

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.