To prevent complications of diabetes and maintain optimal health, it is essential to enhance patients’ knowledge about diabetes, ensure their active participation in treatment, and promote effective self-care management.This study aimed to examine the relationship between self-care management and treatment adherence in individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) who visited the Family Medicine outpatient clinics of XXX Hospital.This cross-sectional study was conducted between February 17, 2025, and May 20, 2025. A total of 201 patients diagnosed with T2DM participated. Self-care management was assessed using the “Chronic Disease Self-Management Scale,” and treatment adherence was measured with the “Medication Adherence Reporting Scale.”Of the participants, 52.2% were women, with a mean age of 58.08±12.39 years. Comorbid chronic conditions were identified in 60% of participants, and diabetes-related complications were found in 13.4%, with retinopathy being the most common. Participants who regularly attended check-ups, engaged in physical activity, and adopted dietary changes showed higher self-care and medication adherence scores. A strong positive correlation was found between self-protection behaviors and treatment adherence. Those who received diabetes education had significantly higher scores in both scales. However, no significant difference was observed in social protection levels in certain comparisons.Higher levels of self-care management were associated with better treatment adherence. These findings emphasize the vital importance of structured diabetes education and supportive care practices in improving treatment adherence and health outcomes among individuals with diabetes.Strengthening self-care abilities and promoting lifestyle changes should be prioritized in diabetes care to achieve better clinical results.

Diabetes is a leading cause of morbimortality worldwide, with substantial socioeconomical impact. Health literacy supports informed decisions, appropriate behaviours, and effective self-management. Evidence shows that interventions designed to strengthen health literacy can improve disease-related knowledge and promote healthier practices.This pilot project aimed to enhance diabetes-related literacy, encourage healthier behaviours, and reinforce patients, caregivers, and primary care team connections. It targeted adults with any type of diabetes and their caregivers followed at the Areeiro Family Health Unit. Conducted between 19th September and 17th October 2025, it consisted of five weekly sessions, one introductory and four structured and educational sessions. These covered basic concepts of diabetes pathophysiology, complications, and management principles; nutrition guidance; diabetic foot care; and the role of physical activity, concluding with an outdoor educational walk.  Strengths included multidisciplinary involvement, small-group dynamics, and high participant engagement. A limitation was the absence of formal outcome measurement, preventing objective evaluation of effectiveness.Engagement was strong and sustained, with positive feedback throughout. The small-group format and interaction with the healthcare team appeared to strengthen motivation and adherence. It emphasised the importance of tailoring content to community needs. Future interventions should include measurable outcomes, broaden participation, and be adapted to other non-communicable diseases.This project proved feasible and well-received, highlighting the value of primary care-based, interactive education. Even though there was no formal evaluation of outcomes, participants described the sessions as informative, reported increased motivation to implement healthier lifestyle measures, and appreciated the connections created between themselves and the health professionals. Multidisciplinary collaboration and proximity of care may strengthen long-term self-management and adherence.This intervention highlights the value of structured, community-oriented health-literacy programmes within primary care suggesting meaningful benefits for patient empowerment, therapeutic relationships and adherence. Expanding similar initiatives could contribute to better chronic disease control and populational health.

Diabetes mellitus (DM) is a prevalent chronic condition, affecting 13.3% of the Portuguese population aged 20 to 79 years. In end-of-life care, the goals of diabetes management differ substantially from those applied in earlier disease stages. The clinical emphasis shifts away from strict glycaemic control towards prioritising patient comfort, minimising treatment burden, and preventing acute metabolic complications such as hypoglycaemia and dehydration. Conventional long-term markers, including glycated haemoglobin (HbA1c), become less clinically relevant as therapeutic decisions rely mainly on short-term symptom control and patient-centred goals.The objective of this review was to summarise best practices for the management of DM at the end of life, with particular focus on therapeutic simplification, prevention of acute glycaemic events, and alignment of treatment with palliative-care principles.A narrative review was conducted drawing on current clinical guidelines—particularly those of the American Diabetes Association—and relevant scientific literature addressing diabetes management in palliative-care contexts. Sources were analysed to identify recommended treatment targets, pharmacological strategies, and approaches that minimise discomfort and optimise quality of life.Across the literature, glycaemic targets are consistently relaxed in end-of-life settings, with acceptable capillary glucose values generally ranging between 180 and 360 mg/dL, provided they do not cause symptoms. Measurement of HbA1c is deprioritised due to its limited applicability in short prognostic horizons. Simplifying therapy is central: in type 2 DM, gradual discontinuation of oral antidiabetic agents is often appropriate; in type 1 DM, low-dose basal insulin may be continued to prevent ketoacidosis. A palliative approach emphasises comfort, vigilance for hypoglycaemia, symptom relief, and ongoing adaptation of treatment based on clinical status and patient preferences.Evidence indicates that metabolic control at the end of life should focus on avoiding symptomatic extremes rather than achieving strict targets. Diet can be liberalised, and treatment intensity reduced. Nevertheless, further research is needed to strengthen evidence-based recommendations in this field.Therapeutic simplification and symptom-focused management represent best practice for DM at the end of life. Aligning treatment with palliative-care principles improves comfort and reduces the risk of metabolic complications. Continued investigation is required to support consistent clinical decision-making. Keywords: Diabetes Mellitus; Palliative Care; Hypoglycemia; Insulin

Diabetic foot complications contribute substantially to morbidity, hospitalisation and lower-limb amputation worldwide. Early detection of neuropathy, peripheral arterial disease and structural abnormalities is central to effective prevention. WONCA Europe highlights the importance of prevention, continuity, quality improvement and workforce development in primary care. Despite clear guidelines, variability in assessment technique and clinical confidence persists across healthcare teams, underscoring the need for structured, evidence-based training.A multidisciplinary education programme was developed incorporating guideline-based teaching, pathophysiology, risk classification frameworks and practical demonstrations. Training covered anatomy of the diabetic foot, mechanisms of neuropathy and vascular disease, monofilament testing, pulse palpation, visual inspection techniques, assessment of footwear and early identification of high-risk findings. Participants engaged in supervised hands-on practice. Evaluation included pre- and post-training knowledge assessments, direct skills observation and structured staff feedback to assess confidence, perceived relevance and areas for ongoing support.Challenges may include limited time for training, variability in prior experience and the need for ongoing competency refreshers to ensure sustainability.Providing structured education is expected to improve standardisation of diabetic foot assessment across primary care, enhance early detection of risk factors and strengthen staff communication with patients regarding self-care and prevention. Increased confidence in assessment technique supports more proactive management and consistent delivery of preventative advice.A structured diabetic foot assessment education programme can strengthen quality of care, improve workforce capability and reduce the risk of preventable foot complications. Embedding such training within primary care aligns with WONCA principles by enhancing prevention, continuity, professional development and patient safety, ultimately supporting better long-term outcomes for individuals living with diabetes.

Diabetes mellitus (DM) is a major contributor to global morbidity, mortality and healthcare burden. Cardiovascular complications—including stroke and myocardial infarction—and microvascular complications such as chronic kidney disease, retinopathy and neuropathy significantly reduce quality of life and increase long-term care needs. WONCA Europe emphasises prevention, patient empowerment, health literacy and continuity of care as core principles of family medicine. Structured diabetes education supports these goals by improving understanding of disease mechanisms, risk factors and early symptom recognition, enabling patients to participate actively in self‑management.A patient-centred education programme was developed using interactive teaching methods, visual resources and practical demonstrations. Content included mechanisms and risk factors for major complications, warning signs, preventive strategies, lifestyle modification, medication adherence and glucose monitoring. Participants engaged in complication-specific self-care discussions. Evaluation measures included pre‑ and post‑session knowledge assessments, feedback questionnaires and indicators of behavioural change such as adherence to monitoring or attendance of screening. Qualitative feedback was analysed thematically to explore confidence, perceived understanding and barriers to effective self‑management.Challenges include engagement, tailoring materials to diverse learning needs and ensuring continuity of education beyond the initial sessions. Strengthening communication between clinicians and patients was identified as a key facilitator of effective behaviour change.Improved awareness of complications is anticipated to support earlier recognition of symptoms, enhance engagement with treatment and increase uptake of preventive interventions. Interactive, visual and accessible education improves comprehension and address varying levels of health literacy.A structured diabetes complications education programme has the potential to significantly improve patient knowledge, encourage proactive self‑management and reduce the incidence and progression of diabetes-related complications. Integrating such programmes within routine primary care aligns with WONCA principles by enhancing prevention, continuity and patient empowerment, ultimately improving long‑term outcomes and quality of life.

Therapeutic inertia remains a major barrier to effective chronic disease management. In type 2 diabetes mellitus (T2DM), this phenomenon is well documented and contributes to delays in achieving glycaemic targets and increased risk of complications. Prediabetes, a clinical state preceding T2DM, is equally important: cardiometabolic risk increase, and microvascular complications may develop. Despite its significance, prediabetes frequently receives insufficient attention in primary care, creating a potential area for therapeutic inertia among general practitioners (GPs).The aim of this study was to assess the 1) knowledge, 2) attitudes, 3) clinical practice of family physicians in Polan in relation to prediabetes management. We tested the hypothesis that the actual knowledge of physicians is lower than declared, which translates into attitudes and clinical practice.A cross-sectional online survey (Computer-Assisted Web Interviewing, CAWI) was developed and distributed to family physicians/general practitioners in Poland via professional mailing lists, social media channels, and communication platforms of the Polish Society of Family Medicine (PTMR). The questionnaire consisted of 20 items across the following domains: (1) knowledge of prediabetes diagnostic criteria; (2) attitudes toward preventive screening; (3) clinical practices related to lifestyle counselling and pharmacologic management; and (4) perceived clinical relevance of prediabetes. Participation was voluntary and anonymous.The survey is expected to provide detailed insights into current knowledge, screening behaviours, and management approaches applied by Polish GPs. Anticipated findings include identifying gaps consistent with therapeutic inertia observed in T2DM management, such as underuse of recommended diagnostic tests, delayed initiation of interventions, and low prioritization of prediabetes in clinical workflows. These results may reveal discrepancies between guideline recommendations and real-world practice.Based on other research conducted by the PTMR, we observe therapeutic inertia in various areas (e.g. pain management) resulting from a false assessment of GPs of their own high level of knowledge combined with suboptimal clinical practice and false beliefs.The expected outcomes will support the identification of specific educational needs among GPs in Poland. Based on these findings, the PTMR plans to design targeted educational interventions aimed at reducing therapeutic inertia, strengthening early detection, and improving the overall quality of prediabetes management in primary care.