Diabetology in Primary Care Practice

Focus areas of diabetology care

• Treatment planning according to national guidelines: Guideline-compliant treatment according to the National Care Guideline Type 2 Diabetes Mellitus^[1]
• Insulin therapy: ICT, BOT, or mixed insulins — adapted based on individual situation with adjustments during follow-up
• CGM/FGM: Continuous glucose monitoring for data-driven therapy optimization
• Nutritional counseling: Structured nutritional education through additional qualifications
• Digital health apps: Use of digital health applications to support therapy
• Follow-up checks: Regular monitoring with treatment plan adjustments

Considering the connections

Experience in primary care practice shows that the combination of obesity, obstructive sleep apnea, and diabetes mellitus is a common disease pattern. Sleep apnea worsens insulin sensitivity^[2], overweight increases insulin resistance, and both factors significantly complicate blood sugar control. Weight reduction is a powerful lever: In the DiRECT study (Lean et al., 2018), 46% of participants achieved diabetes remission through structured weight loss.^[3] Effective therapy must therefore:

• Clarify sleep medicine questions (is sleep apnea present?)
• Support weight management strategically
• Establish stable metabolism while considering all influencing factors