TOPLINE:

Adults aged 60 years or older with type 2 diabetes (T2D) had the lowest mortality when their interprofessional care leaned slightly towards nurses; however, care dominated by GPs was associated with the highest mortality.

METHODOLOGY:

• Researchers in Finland conducted a cohort study using real-world primary care records to examine the impact of the level of nurse and GP interprofessional care on all-cause and cause-specific mortality among 11,020 patients aged 60 years or older with T2D (46%-61% women).
• The distribution between nurse and GP appointments was measured using an interprofessional care index, with negative values indicating nurse-centred care and positive values indicating GP-centred care.
• Patients were classified into the following six groups on the basis of the index value: those with the most nurse-centred care, slightly nurse-centred care, evenly distributed care, slightly GP-centred care, most GP-centred care, and no visits.
• Analysed causes of death included cardiovascular diseases, dementia, digestive system diseases, cancer, and respiratory diseases.
• The mean follow-up duration was 7.3 years.

TAKEAWAY:

• The interprofessional care index was shifted towards nurse-centred care, with a median value of -0.33.
• Mortality was lowest in the slightly nurse-centred care group (standardised mortality ratio [SMR], 0.92; 95% CI, 0.87-0.97) and rose as care became more nurse or GP centred; mortality was highest in the most GP-centred care group (SMR, 2.60; 95% CI, 2.27-3.19).
• Across all groups, cardiovascular diseases were the leading cause of death, and cancer and dementia alternated as the second and third most common causes.

IN PRACTICE:

"This study is an opening on the optimal level of interprofessional T2D care, showing variation in all-cause mortality associated with the level of interprofessional care index in a public PHC [primary healthcare] setting," the authors wrote.

SOURCE:

This study was led by Eero Mellanen, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. It was published online on February 09, 2026, in Primary Care Diabetes.

LIMITATIONS:

The study lacked data on several important factors, including the use of home care unit services, smoking status, and the duration and complications of diabetes. The comorbidity index may not have fully captured the tendency of patients with more severe conditions to visit physicians more frequently. Patients may have developed conditions requiring more frequent appointments during follow-up, potentially affecting the interprofessional care index values.

DISCLOSURES:

This study was supported by the Finnish Medical Society, and the authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.