medwireNews: UK researchers find people with type 2 diabetes are increasingly being cared for in specialist settings, rather than by family doctors.
The steepest reduction in primary care was seen among people with multiple cardiometabolic comorbidities, for whom primary care consultations decreased by 50.1% between 2000 and 2018, while secondary care contacts increased by 33.3% during 2003–2018. The corresponding rates for people with type 2 diabetes but without cardiometabolic comorbidity were 45.0% and 54.4%.
The average appointment duration also increased during the study period, by 37.3% and 36.0% in people with and without cardiometabolic comorbidities, respectively.
The research by David Webb (Leicester General Hospital, UK) and team is based on data from 141,328 people with type 2 diabetes (58.8%) or cardiovascular disease (41.0%) identified in the UK’s Clinical Practice Research Datalink. Of these, 260 were simultaneously diagnosed with both conditions and a further 11,881 became comorbid during follow-up.
The overall consultation rate was higher in people with cardiometabolic comorbidity than those without, at 18.5 versus 13.5 per person–year. Primary care consultation rates were 12.7 versus 11.2 per person–year, and specialist care rates were 6.0 versus 2.5 per person–year.
The results highlight “a significant burden of healthcare delivery” in people with cardiometabolic comorbidities, say the researchers.
“Currently the healthcare framework in many developed countries is based on treating single-diseases individually,” write Webb and team in Cardiovascular Diabetology.
They note: “This may not be the best model of care for individuals with multimorbidity.”
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Cardiovasc Diabetol 2022; 21: 8