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Research ArticleSpecial Reports

Diabetes Management: A Case Study to Drive National Policy Change in Primary Care Settings

Raveendhara R. Bannuru, Francisco Prieto, Lisa Murdock and Elise Tollefson
The Annals of Family Medicine November 2024, 22 (6) 550-556; DOI: https://doi.org/10.1370/afm.3175
Raveendhara R. Bannuru
1American Diabetes Association, Arlington, Virginia
MD, PhD, FAGE
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Francisco Prieto
2Sutter Health Systems, Elk Grove, California
MD
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Lisa Murdock
1American Diabetes Association, Arlington, Virginia
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  • For correspondence: LMurdock@diabetes.org
Elise Tollefson
1American Diabetes Association, Arlington, Virginia
MA
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Abstract

Despite medical advances, diabetes management remains a considerable challenge in the United States, with little to no improvement in patient outcomes and stark disparities in underserved communities. One acute challenge is that, as the US population with diabetes grows steadily—numbering 38.4 million people today—there are too few endocrinologists available to treat the disease and the burdens on primary care professionals, who treat more than 90% of cases currently, are staggering. This disconnect between need and care capacity presents what may be the greatest of many threats to the care of diabetic Americans. To understand what is required to solve this need-to-capacity mismatch, we examine the critical role of primary care professionals and propose national policy approaches to empower and improve the nation’s primary care architecture for the nearly 12% of Americans who have diabetes. Policy recommendations encompass the integration of the chronic care model and the patient-centered medical home approach, expansion of workforce development initiatives, and payment reform to incentivize team-based care with the aim of ensuring equitable access to essential diabetes management tools. We urge policy makers to prioritize primary care workforce development, enhance reimbursement models, and implement strategies to mitigate disparities in diabetes care. Evidence reviewed here highlights the critical need for a comprehensive, multidimensional approach to diabetes management in primary care, emphasizing the importance of decisive action by policy makers to equip primary care professionals with the necessary resources and support to effectively address the nation’s diabetes epidemic.

Key words:
  • primary care
  • access to care
  • team-based care
  • diabetes management
  • self-management
  • health equity
  • health care workforce
  • health policy
  • social determinants of health
  • vulnerable populations
  • clinician payment
  • payment reform
  • clinician education
  • health outcomes
  • Received for publication May 13, 2024.
  • Revision received August 7, 2024.
  • Accepted for publication August 8, 2024.
  • © 2024 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 22 (6)
The Annals of Family Medicine: 22 (6)
Vol. 22, Issue 6
November/December 2024
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Diabetes Management: A Case Study to Drive National Policy Change in Primary Care Settings
Raveendhara R. Bannuru, Francisco Prieto, Lisa Murdock, Elise Tollefson
The Annals of Family Medicine Nov 2024, 22 (6) 550-556; DOI: 10.1370/afm.3175

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Diabetes Management: A Case Study to Drive National Policy Change in Primary Care Settings
Raveendhara R. Bannuru, Francisco Prieto, Lisa Murdock, Elise Tollefson
The Annals of Family Medicine Nov 2024, 22 (6) 550-556; DOI: 10.1370/afm.3175
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  • diabetes management
  • self-management
  • health equity
  • health care workforce
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  • social determinants of health
  • vulnerable populations
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