An Integrated Multidisciplinary Model for Diabetes Screening and Complication Prevention: Roles of Nursing, Health Informatics, Laboratory Testing, Dentistry, Nutrition, and Optometry

Abstract

Background: Diabetes prevalence has risen sharply worldwide. WHO reports that the number of people living with diabetes increased from 200 million in 1990 to 830 million in 2022, while IDF estimates that 589 million adults aged 20–79 years were living with diabetes in 2024 and that almost one in two cases remained undiagnosed. Preventing complications therefore depends on both earlier case detection and reliable delivery of longitudinal risk-reduction processes.

Objective: To develop an evidence-based academic manuscript proposing an integrated multidisciplinary model for diabetes screening and complication prevention, explicitly defining the roles of nursing, health informatics, laboratory testing, dentistry, nutrition, and optometry in an unspecified health-system setting.

Methods: A structured narrative review and integrative synthesis was undertaken using English-language official guidance and recent primary or synthesis literature, prioritising WHO, ADA, IDF, and NICE documents and major peer-reviewed journals. The synthesis focused on adult type 2 diabetes screening and prevention pathways, although selected evidence on type 1 screening, pregnancy, and young people was considered where it informed pathway design or surveillance timing. Because no country or service model was specified, recommendations were abstracted into a context-adaptable model with “minimum essential” and “enhanced digital” components.

Results: An effective integrated model begins with risk assessment in adults with overweight or obesity and additional risk factors, and universal screening from age 35 years for all others using fasting plasma glucose, 2-hour plasma glucose during a 75 g oral glucose tolerance test, or laboratory HbA1c. People with prediabetes require annual retesting and referral to structured lifestyle intervention targeting at least 5–7% weight loss and at least 150 minutes per week of moderate physical activity. After diabetes is diagnosed, the annual core prevention bundle should include HbA1c or equivalent glycaemic assessment, blood pressure, lipid profile, renal surveillance with creatinine/eGFR and urine albumin-to-creatinine ratio, foot examination, eye screening, smoking review, weight/BMI review, nutrition care, and oral/periodontal review. Nursing improves coordination and self-management; informatics improves coverage and treatment promptness; laboratory systems improve diagnostic accuracy and surveillance; dentistry contributes oral risk control and opportunistic dysglycaemia detection; nutrition reduces incident diabetes and improves metabolic outcomes; and optometry-based or teleophthalmology models can expand retinal screening capacity and improve cost-efficiency.

Conclusions: Diabetes complication prevention is best delivered through a common pathway with shared accountability across disciplines. The strongest model uses nursing-led coordination, registry-supported informatics, standardised laboratory surveillance, proactive nutrition intervention, oral-health integration, and accessible retinal care pathways. Policy support should prioritise preventive financing, interoperable information systems, workforce training, and equity-oriented monitoring.