Role of Family Medicine in Acute Diabetic Emergencies and Related Healthcare Utilization: A Systematic Review

This systematic review synthesized evidence on whether structured family medicine-based or primary care diabetes management is associated with fewer acute diabetic emergencies and lower related healthcare utilization among adults with diabetes mellitus.The review was registered in the International Prospective Register of Systematic Reviews (CRD420261359851) and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.English-language primary studies published between 2015 and 2026 were identified through PubMed/MEDLINE, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials.Two reviewers independently screened eligible studies and extracted data.Risk of bias and certainty of evidence were assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.Due to substantial heterogeneity, findings were synthesized narratively.Twenty studies from 13 countries or regions were included.Seven studies assessed acute diabetic outcomes, while 13 evaluated healthcare utilization.None reported diabetic ketoacidosis or hyperosmolar hyperglycemic state as individual endpoints.Most family medicine and primary care studies reported fewer acute glycemic events.Most utilization studies reported reductions in diabetes-related or potentially avoidable hospitalization or emergency care use.However, findings were inconsistent across studies.The certainty of evidence was very low for both outcome domains.Family medicine-based and primary care diabetes management may be associated with fewer acute events and lower utilization.However, the evidence is insufficient to establish that these models prevent specific diabetic emergencies, particularly diabetic ketoacidosis and hyperosmolar hyperglycemic state.Further studies using clearly defined emergency-specific outcomes are needed.