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Community-Based Models for Type 2 Diabetes Care: A Review of Effectiveness, Implementation, and Health System

Vandana Esht1, Madhur Verma2, Shazia Malik1

  • 1Physical Therapy Department, College of Nursing and Health Sciences, Jazan University, Jizan, Saudi Arabia.

Advances in Therapy
|January 7, 2026
PubMed
Summary

Community-based diabetes care models improve type 2 diabetes management in low-resource settings. Integrating these programs into health systems enhances effectiveness and sustainability for better patient outcomes.

Keywords:
Community health workers (CHWs)Community-based careHealth system integrationImplementation scienceType 2 diabetes

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Area of Science:

  • Global health
  • Public health
  • Diabetes management

Background:

  • Type 2 diabetes mellitus (T2DM) poses significant challenges in low- and middle-income countries (LMICs) due to healthcare system limitations.
  • Community-based diabetes care models are emerging as scalable solutions to improve self-management and service accessibility.

Purpose of the Study:

  • To synthesize global evidence on community-based T2DM care models.
  • To classify intervention typologies and assess their alignment with the diabetes care continuum.
  • To evaluate the effectiveness and implementation characteristics of these models.

Main Methods:

  • A narrative review of studies from January 2010 to March 2025 was conducted.
  • Searches included PubMed, Scopus, Web of Science, and Embase.
  • Interventions were categorized and evaluated using the RE-AIM framework and integration models.

Main Results:

  • Eleven studies showed that community health worker (CHW)-led and hybrid models were prevalent in LMICs.
  • Interventions led to significant improvements in HbA1c, BMI, and self-efficacy.
  • Successful models integrated into public health systems or community platforms demonstrated better adoption and maintenance; digital tools improved reach but faced engagement challenges.

Conclusions:

  • Community-based T2DM care models are scalable and sustainable strategies for disease control.
  • Integration into national health platforms, supervision, and digital tools enhance implementation.
  • Prioritizing integration, financing, and CHW capacity is crucial for successful scale-up.