Primary care experience and remission of type 2 diabetes: a population-based prospective cohort study
Open accessAbstract
Background: Remission of Type 2 diabetes is achievable through dietary change and weight loss. In the UK, lifestyle advice and referrals to weight loss programmes predominantly occur in primary care where most Type 2 diabetes is managed. Objective: To quantify the association between primary care experience and remission of Type 2 diabetes over 5-year follow-up. Methods: A prospective cohort study of adults with Type 2 diabetes registered to 49 general practices in the East of England, UK. Participants were followed-up for 5 years and completed the Consultation and Relational Empathy measure (CARE) on diabetes-specific primary care experiences over the first year after diagnosis of the disease. Remission at 5-year follow-up was measured with HbA1c levels. Univariable and multivariable logistic regression models were constructed to quantify the association between primary care experience and remission of diabetes. Results: Of 867 participants, 30% (257) achieved remission of Type 2 diabetes at 5 years. Six hundred twenty-eight had complete data at follow-up and were included in the analysis. Participants who reported higher CARE scores in the 12 months following diagnosis were more likely to achieve remission at 5 years in multivariable models; odds ratio = 1.03 (95% confidence interval = 1.01–1.05, P = 0.01). Conclusion: Primary care practitioners should pay greater attention to delivering optimal patient experiences alongside clinical management of the disease as this may contribute towards remission of Type 2 diabetes. Further work is needed to examine which aspects of the primary care experience might be optimized and how these could be operationalized.
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The skills and empathy of practitioners may overcome any diet-specific effects on weight loss by providing consistent evidence-based support.
“The skills and empathy of practitioners may overcome any diet-specific effects on weight loss by providing consistent evidence-based support [70].”
There is consistent evidence that remission should be attempted as early as possible from diabetes diagnosis.
“There is therefore consistent evidence that remission should be attempted as early as possible from diabetes diagnosis [70, 96].”
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- Authors
- Dambha-Miller, H., Day, A., Kinmonth, A. L., & Griffin, S. J.
- Affiliations
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- University of Cambridge (GB)
- Venue
- Family Practice
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-09-12
- Volume
- 38
- Issue
- 2
- Pages
- 140-145
- ISSN
- 0263-2136 (ISSN-L)
- 1460-2229
- PMC
- PMC8006762
- OpenAlex
- W3086482982
- Cited by
- 12
- References
- 39
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 3 · 2022: 4 · 2021: 1
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Family Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Apollo (University of Cambridge) (submittedVersion)
- Apollo
- Funders
- Wellcome Trust (G061895)
- Medical Research Council (G0001164)
- NIHR Health Technology Assessment Programme (RP-PG-0606-1259)
- National Health Service R&D
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- type 2 diabetes remission, patient experience, CARE measure, general practice, HbA1c, lifestyle advice, slimming program, patient-clinician relationship
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Humans, Primary Health Care, Prospective Studies, Cohort Studies, Weight Loss
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