Advancing Diabetes Remission within the Primary Health Care System: A Conceptual Analysis of Nurse Practitioners’ Roles and Opportunities
Keywords:
Diabetes remission, Nurse practitioner, Primary care, Type 2 diabetesAbstract
Type 2 diabetes mellitus remains a major public health concern in Thailand. Despite standardized treatment guidelines, the rate of glycemic control remains suboptimal, reflecting the limitations of the conventional disease-control approach that focuses on symptom management rather than metabolic restoration. This highlights the need to adopt the concept of diabetes remission, which emphasizes addressing underlying causes and restoring sustainable metabolic balance.
This article presents a conceptual analysis using the chronic care model as the conceptual framework to examine three core aspects: 1) the concept of diabetes remission, which focuses on restoring normal glycemic levels without continuous use of glucose-lowering medications: evidence suggests that intensive weight reduction, dietary modification, and proactive community-based health promotion can help some patients achieve remission; 2) the role of nurse practitioners as leaders in integrated care, coordinating multidisciplinary teams across hospitals, families, and communities, while utilizing digital health technologies to monitor, empower, and support patients’ self-management continuously; and 3) the opportunities and strategies in primary health care, including the implementation of diabetes remission clinics and diabetes schools, real-time health data integration, and the establishment of community networks to support continuity of care.
Thus, advancing diabetes remission requires an integrated conceptual framework for sustainable diabetes remission care that links the roles of nurse practitioners, digital technologies, and community participation. Such integration can strengthen Thailand’s primary health care system, enhance remission rates, reduce the long-term disease burden, and promote the sustainability of the national health system.
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