Evidence map›Paper›PMID 40217473›Full record

Observational studyBMC primary care2025

Referral reasons of type 2 diabetes patients from general practitioners to diabetes specialists: a cross-sectional observational study.

Antonin Ludinard, Jan Chrusciel, Stephane Sanchez

Abstract readObservational Study
In one paragraph

Observational study in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Antonin LudinardAmbonnay General Practice, Ambonnay, 51150, France.
Jan ChruscielDepartment of Public Health, Hôpitaux Champagne Sud, Troyes, France.ORCID 0000-0002-8364-6506
Stephane SanchezDepartment of Public Health, Hôpitaux Champagne Sud, Troyes, France. stephane.sanchez@hcs-sante.fr.ORCID 0000-0002-0925-6948

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetes is a global public health concern. The follow-up of patients with diabetes is often undertaken by general practitioners (GPs), but referral rates to specialists show variations. The primary objective of this study was to describe the factors associated with the referral of type 2 diabetes patients from GPs to diabetes specialists.

methodsAn observational survey-based cross-sectional study was conducted with GPs practicing in France between 17 May 2023 and 13 July 2023. Physician characteristics, referral rate and attitudes towards referral were collected. Characteristics associated with frequent referrals were evaluated using a multivariable logistic regression model.

resultsA total of 325 GPs located in 52 departments (mean age 43 years) responded to the questionnaire. Most responding GPs were women (63%). Most GPs (76%) stated that they rarely or never referred their patients with type 2 diabetes to a diabetes specialist. The most frequent barrier to referral was delays in accessing a specialist (57%), and it was often cited both in the infrequent referral group (56%) and the frequent referral group (58%). In multivariable analysis, higher referral rates were associated with physician age (Odds Ratio OR per year 1.04, 95% Confidence Interval CI 1.01 to 1.07), diabetes care network membership (OR 2.81, 95% CI 1.15 to 6.88), referrals motivated by the introduction of insulin therapy (OR 2.73, 95%CI 1.44 to 5.34) or to consolidate communication about therapeutics and compliance (OR 2.34, 95%CI 1.18 to 4.67), expecting advice regarding new medication such as SGLT-2 inhibitors (OR 2.08, 95% CI 1.11 to 3.98), and the mention of patient refusal as one of the main barriers to referral (OR 1.85, 95% CI 1.03 to 3.38) were associated with higher referral rates. Conversely, doubts about the added value of the diabetes specialist was associated with infrequent referrals (OR 0.25, 95% CI 0.08 to 0.66).

conclusionsThese factors indicate a possible role for lasting professional relationships, where trust built over shared network memberships and years of practice can facilitate referrals. Newly established GPs may find it beneficial to contact specialists in their region to discuss referral procedures. This could facilitate the referral of patients and improve access to specialist care.

Indexed as

Diabetes Mellitus, Type 2General PractitionersPractice Patterns, Physicians'Referral and ConsultationAdultAttitude of Health PersonnelCross-Sectional StudiesFemaleFranceHumansMaleMiddle AgedSpecializationSurveys and QuestionnairesDiabetesDiabetologistGeneral practitionerHealthcare networksPrimary careReferral

Identifiers

PMID40217473
PMCPMC11987207

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.