Stock image from Freepik used for representational purposes
Doha: A study published in BMJ Public Health has shed light on the significant challenges and service delivery gaps in the management of diabetes among patients with poor blood sugar control in Qatar’s primary healthcare system.
It explores why individuals with poorly controlled Type 2 diabetes continue to miss glycemic (blood sugar ) targets, despite receiving care in Qatar’s primary health system.
Qatar ranks among the countries with the highest diabetes prevalence globally, and a substantial number of people visiting non-communicable disease (NCD) clinics in the nation’s primary care facilities are living with diabetes.
Alarmingly, a large proportion of these individuals have glycosylated haemoglobin (HbA1c) levels above the recommended target range — a key marker of long-term blood sugar control.
The qualitative study, titled “Key service delivery processes, challenges and barriers to healthcare access for managing diabetes outside target HbA1c levels in primary care settings in Qatar”, explored the experiences and perspectives of both people with diabetes and healthcare professionals (HCPs) working in primary health centres across Qatar.
Researchers conducted in-depth interviews with healthcare providers (physicians, nurses, dietitians) and patients whose HbA1c levels remained above recommended thresholds.
Their goal was to examine systemic, professional, and individual factors that challenge effective diabetes management.
The study identified four key barriers that hinder effective management of uncontrolled Type 2 diabetes in Qatar’s primary healthcare system.
First, fragmented care coordination emerged as a significant issue.
Healthcare professionals described disjointed referral pathways, limited engagement between disciplines, and a lack of unified follow-up plans.
From the patients’ perspective, frequent changes in healthcare providers and delays in referrals contributed to inconsistent and fragmented care experiences.
Second, clinic workload and resource constraints posed major challenges.
Due to staff shortages, consultations were often limited to less than 15 minutes, restricting opportunities for meaningful patient education and individualised management.
Healthcare providers also noted a lack of time for essential services such as behavioural counselling and regular follow-ups.
A third major barrier involved patient-related challenges.
Many patients struggled to adapt to the lifestyle changes required for effective diabetes management, such as adhering to dietary restrictions and maintaining consistent medication routines.
Both providers and patients cited poor understanding of diabetes care and the presence of psychosocial obstacles—including low motivation, insufficient family or social support, and financial difficulties—as key factors.
Also language barriers and cultural misunderstandings often impeded effective communication between patients and providers.
Patients reported that the advice they received was sometimes too generic, overly medical, or culturally irrelevant, making it hard to apply in their daily lives.
Despite these challenges, the study offers several promising strategies to improve diabetes care.
It recommends stronger multidisciplinary integration, with dietitians, nurses, and diabetes educators working collaboratively to ensure continuity of care.
Extended consultation times are also suggested to provide space for behaviour change support and more in-depth patient education.
Additionally, the adoption of tailored care models that are culturally and linguistically appropriate could improve patient engagement and understanding.
Finally, empowering patients through self-management initiatives—such as peer support groups and digital tools for education and reminders—was seen as a key step toward better long-term outcomes.
The study concludes that Qatar’s primary care system can significantly improve diabetes outcomes by implementing integrated care models and testing novel, evidence-based interventions.
Strengthening patient education, improving communication, and leveraging technology are key to empowering patients to better manage their condition.
“These strategies are essential to improving self-care, achieving better health outcomes, and reducing the burden on the healthcare system,” the authors note.
“They represent a shift toward evidence-based, patient-centred care.”
