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. 2025 Nov 14;26(1):362.
doi: 10.1186/s12875-025-03040-4.

Providing diabetes prevention services and navigating care transitions: perspectives from primary care providers

Mary H Smart  1 , Yuka Asada  2 , Deci Limpoco  2 , Janet Y Lin  3 , Brian T Layden  4   5 , Yuval Eisenberg  4 , A Simon Pickard  6 , Lisa K Sharp  7 , Alana Biggers  8 , Angela Kong  6
Affiliations

Providing diabetes prevention services and navigating care transitions: perspectives from primary care providers

Mary H Smart et al. BMC Prim Care. .

Abstract

Background: This qualitative study examined how primary care providers (PCPs) prioritize addressing diabetes prevention with patients newly diagnosed with prediabetes and identified barriers and facilitators to providing diabetes prevention services (DPS). To examine transitions of care, we also evaluated how PCPs received and acted on screening information obtained outside of a primary care visit among their patients with prediabetes.

Methods: We interviewed PCPs practicing in Chicago using semi-structured interviews guided by the updated Consolidated Framework for Implementation Research (CFIR 2.0) from March to May 2023. Framework analysis in combination with hybrid coding was used to analyze transcripts.

Results: Nineteen PCPs were interviewed, and most (58%) prioritized talking to patients with prediabetes about diabetes prevention. Major themes identified included: (1) social determinants of health (SDOH) undermining diabetes prevention care, (2) perceptions of barriers and facilitators differing by provider background, and (3) delay of DPS due to prioritizing the patient's other needs. Providers noted challenges in sharing information across health systems despite existing interoperability platforms.

Conclusions: Our study observed challenges in providing DPS, particularly among PCPs serving patients impacted by SDOH. We also identified opportunities for improving transitions of care and engagement between patients with prediabetes and PCPs.

Keywords: Diabetes screening; Prediabetes; Primary care; Transitions of care.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board at the University of Illinois Chicago reviewed and approved the study (Protocol 2021 − 1048) on October 8, 2021. Informed consent was obtained from all participants included in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References

    1. Centers for Disease Control and Prevention. National Diabetes Statistics Report website. Updated June 29. 2022. Accessed October 7, 2023. https://www.cdc.gov/diabetes/data/statistics-report/index.html
    1. Cowie CC, Casagrande SS, Menke A, Cissell MA, Eberhardt MS, Meigs JB, et al, editors. Diabetes in America. 3rd ed. Bethesda: National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018. Please see URL: https://pubmed.ncbi.nlm.nih.gov/33651524/. PMID: 33651524. - PubMed
    1. American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care. May 2018;41(5):917–928. 10.2337/dci18-0007 - PMC - PubMed
    1. ElSayed NA, Aleppo G, Aroda VR, et al. 3. Prevention or delay of type 2 diabetes and associated comorbidities: standards of care in diabetes-2023. Diabetes Care Jan. 2023;1(Suppl 1):S41–8. 10.2337/dc23-S003. - PMC - PubMed
    1. US Preventive Services Task Force. Screening for prediabetes and type 2 diabetes: US preventive services task force recommendation statement. JAMA. 2021;326(8):736–43. 10.1001/jama.2021.12531. - PubMed

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