Current clinical practices and inclusion of type 2 diabetes as a condition for primary referral to physiotherapy – A physiotherapist’s perspective

Abstract: BACKGROUND: The prevalence of diabetes is increasing at an alarming rate and so is the rate of its associated complications. Physiotherapy practice in this domain includes exercise prescription for managing type 2 diabetes mellitus (T2DM), as regular exercise has been shown to decrease insulin resistance, improve insulin sensitivity, and thereby regulate glucose levels. OBJECTIVE: To assess physiotherapists’ perspectives on the need for inclusion of physiotherapy within primary care protocols and to examine the current clinical practices in the management of T2DM, with the aim of identifying gaps in the existing healthcare system that may support the inclusion of T2DM as a condition for primary referral to physiotherapy. METHODOLOGY: A questionnaire was designed under the domains of knowledge, current practices and experiences, multidisciplinary approach, and future implications. A sample size of 96 was determined, and purposive sampling was employed for participant selection. Participants meeting the inclusion criteria were identified and were administered the questionnaire on an interview basis. Data were then analyzed and represented using descriptive statistics RESULTS: Though participants had sufficient knowledge about T2DM, the condition is not commonly treated as a primary referral. Educating patients regarding the importance of exercise was found to be the most challenging aspect of treating diabetic patients. Finally, more efforts are required to include diabetes as a primary condition for referral to Physiotherapy. CONCLUSION: Through this study, it can be concluded that the main barrier to primary referrals was unawareness of the healthcare team and diabetic patients about the physiotherapist’s role in managing diabetes. In addition, integrating physiotherapists into diabetes care teams and establishing clinical guidelines for early referral need to be emphasized to help increase the number of primary referrals.