Global research trends on the links between primary health care and diabetes from 1980 to 2024: a machine learning-based science mapping

Year 2025, Volume: 18 Issue: 4, 2 - 2

Gökben Yaslı , Serkan Alıcı , Muhammet Damar

Abstract

Purpose: A systematic and detailed examination of studies on diabetes can guide the evaluation of healthcare services, the identification of issues, and the implementation of preventive interventions. Therefore, this study aims to assess diabetes research in the primary health care (PHC) field using machine learning-based bibliometric methods.
Materials and methods: In this study, articles related to diabetes in the PHC field were obtained from the Web of Science Core Collection on March 15, 2024. These articles were analyzed using bibliometric methods and the Latent Dirichlet Allocation (LDA) topic modeling technique.
Results: The analysis of the studies revealed that 3.355 articles on diabetes in the PHC field were produced by researchers from 114 different countries, 4.226 institutions, and 12.426 individual researchers. Recent years have shown a growing interest in topics such as obesity, hypertension, chronic diseases, exercise, and physical activity within the PHC field. Topic modeling identified eight distinct latent topic clusters: (1) Diabetes management in PHC, (2) Risk factors and management of diabetes in PHC, (3) Acute and chronic complications of diabetes in PHC, (4) Gestational diabetes, (5) Prediabetes and Type 1 diabetes, (6) COVID-19 and diabetes, (7) Quality of life, awareness, and health education, (8) Current treatment methods and guideline resources.
Conclusion: Primary Care Diabetes and Journal of Family Medicine and Primary Care are the leading journals in PHC-related diabetes research. The studies show a significant overlap between diabetes research and topics such as hypertension and obesity. Future studies in the PHC field are recommended to focus on diabetic retinopathy and diabetic wound research.

Keywords

Primary health care, diabetes, data analysis, sience mapping, topic modeling

Ethical Statement

: There is no need to obtain ethical approval.

Supporting Institution

none

Project Number

none

Thanks

M.Damar was supported by the Scientific and Technological Research Council of Türkiye (TUBITAK) under the TUBITAK 2219 International Postdoctoral Research Fellowship program. He would like to thank the Upstream Lab, MAP, Li Ka Shing Knowledge Institute at the University of Toronto for its excellent hospitality.

1980-2024 yılları arasında birincil sağlık hizmetleri ile diyabet arasındaki ilişkiler üzerine küresel araştırma eğilimleri: makine öğrenmesi tabanlı bilimsel haritalama çalışması

Abstract

Amaç: Diyabetle ilgili yapılan çalışmaların sistematik ve ayrıntılı olarak incelenmesi, sağlık hizmetlerinin değerlendirilmesine, sorunların belirlenmesine ve önleyici müdahalelere rehberlik edebilir. Bu nedenle çalışmamız kullanılan makine öğrenmesi destekli bibliyometrik yöntem ile birincil sağlık hizmetleri (BSH) araştırma alanındaki diyabet araştırmalarını değerlendirmeyi amaçlamıştır.
Gereç ve yöntem: Çalışmamızda 15 Mart 2024 tarihinde Web of Science Core Collection veri kaynağından elde edilen diabet konulu birinci basamak sağlık hizmetleri araştırma alanındaki makaleler bibliyometrik yöntemler ve Latent Dirichlet Allocation (LDA) konu modelleme yöntemi ile analiz etmektedir.
Bulgular: Çalışmalar incelendiğinde BSH alanındaki diyabet konusunda 3,355 makalenin 114 farklı ülkeden, 4,226 farklı kurum ve 12,426 farklı araştırmacı tarafından üretildiği görülmüştür. Son yıllarda birinci basamak sağlık hizmetleri alanında obezite, hipertansiyon, kronik hastalık, egzersiz, fiziksel aktivite konu başlıklarının yoğun ilgi gördüğü görülmüştür. Yapılan konu modellemesi ile sekiz farklı gizli konu kümesi bulunmuştur. Bunlar sırasıyla; (1) BSH’de diyabet yönetimi, (2) BSH’de diyabetin risk faktörleri ve yönetimi (3) BSH’de diyabetin akut ve kronik komplikasyonları (4) gestasyonel diyabet (5) prediyabet, tip 1 diyabet (6) COVID-19 ve diyabet (7) yaşam kalitesi, farkındalık ve sağlık eğitimi, (8) güncel tedavi yöntemleri ve rehber kaynaklar şeklindedir.
Sonuç: Primary Care Diabetes ve Journal of Family Medicine and Primary Care dergileri BSH alanında diyabet araştırmalarında öne çıkan dergilerdir. Diyabet araştırmaları ile hipertansiyon ve obezite konularının yoğun şekilde birlikte işlendiği görülmüştür. Gelecek çalışmalar için BSH alanında diyabetik retinopati ve diyabetik yara çalışmalarının yapılması önerilmektedir.

Keywords

Birinci basamak sağlık hizmetleri, diyabet, veri analizi, bilim haritalama, konu modelleme

Ethical Statement

Etik kurul izni alınmasına gerek yoktur.

Supporting Institution

Yok

Project Number

none

Thanks

M.Damar, TÜBİTAK 2219 Uluslararası Doktora Sonrası Araştırma Burs Programı kapsamında Türkiye Bilimsel ve Teknolojik Araştırma Kurumu (TÜBİTAK) tarafından desteklenmiştir. Toronto Üniversitesi'ndeki Upstream Lab, MAP, Li Ka Shing Knowledge Institute'a mükemmel misafirperverliği için teşekkür eder.

References

• 1. The Lancet. Diabetes: a defining disease of the 21st century. Lancet. 2023;401(10394):2087. doi:10.1016/S0140-6736(23)01296-5
• 2. GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203-234. doi:10.1016/S0140-6736(23)01301-6
• 3. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. doi:10.1016/S0140-6736(20)30925-9
• 4. Sun H, Saeedi P, Karuranga S, et al. IDF diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pr. 2021;183(109119):1-23. doi:10.1016/j.diabres.2021.109119
• 5. Magliano DJ, Boyko EJ, IDF Diabetes Atlas 10th edition scientific committee. IDF Diabetes Atlas. 10th ed. International Diabetes Federation; 2021. Available at: https://www.ncbi.nlm.nih.gov/books/NBK581934. Accessed January 19, 2025
• 6. Saeedi P, Petersohn I, Salpea P, et al. Global and Regional Diabetes Prevalence Estimates for 2019 and Projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th Edition. Diabetes Res Clin Pr. 2019;157(157):107843. doi:10.1016/j.diabres.2019.107843
• 7. Qiu M, Chen S, Chen J, Gao H. Bibliometric study and visual analysis of postoperative diabetes mellitus in kidney transplant recipients based on WoSCC database. Ren Fail. 2025;47(1):2444383. doi:10.1080/0886022X.2024.2444383
• 8. Jia Y, Gu Y, Wang L, Jiang N, Yu X, Tian H. Critical analysis of hot topics in diabetic nephropathy related experimental research: A bibliometric analysis from 2018 to 2024. J Tissue Viability. 2025;34(1):100854. doi:10.1016/j.jtv.2025.100854
• 9. Yasli G, Damar M, Özbiçakci Ş, Alici S, Pinto AD. Primary care research on hypertension: A bibliometric analysis using machine-learning. Medicine (Baltimore). 2024;103(47):e40482. doi:10.1097/MD.0000000000040482
• 10. Porter J, Boyd C, Skandari MR, Laiteerapong N. Revisiting the Time Needed to Provide Adult Primary Care. J Gen Intern Med. 2023;38(1):147-155. doi:10.1007/s11606-022-07707-x
• 11. Lu H, Uddin S, Hajati F, Moni MA, Khushi M. A patient network-based machine learning model for disease prediction: The case of type 2 diabetes mellitus. Appl Intell. 2022;52(3):2411-2422. doi:10.1007/s10489-021-02533-w
• 12. Ding H, Chen Y, Yu M, Zhong J, Hu R, Chen X, Wang C, Xie K, Eggleston K. The Effects of Chronic Disease Management in Primary Health Care: Evidence from Rural China. J Health Econ. 2021;80:102539. doi:10.1016/j.jhealeco.2021.102539
• 13. Savoy M; FAAFP; FABC; CPE; CMQ; FAAPL; Hazlett O'Brien C, Rapacciuolo J. The Role of Primary Care Physicians in Managing Chronic Disease. Dela J Public Health. 2017;3(1):86-93. doi:10.32481/djph.2017.03.012
• 14. Hu Y, Zhao Y, Wu H, Li X, Zeng Q. Global Hotspots and Trends of Diabetic Foot Ulcer Therapy: A Bibliometric Analysis from 2004 and 2023. Int J Low Extrem Wounds. 2025 Jan 8:15347346241311065. doi:10.1177/15347346241311065
• 15. Jia Y, Hu Q, Liao H, Liu H, Zeng Z, Yu H. Global research trends and hotspots in gestational diabetes and long-term cardiovascular health: A bibliometric analysis. Diabetes Metab Syndr. 2024;18(10):103144. doi:10.1016/j.dsx.2024.103144
• 16. Webb EM, Rheeder P, Wolvaardt JE. The ability of primary healthcare clinics to provide quality diabetes care: An audit. Afr J Prim Health Care Fam Med. 2019;11(1):e1-e6. doi:10.4102/phcfm.v11i1.2094
• 17. Vachon B, Huynh AT, Breton M, Quesnel L, Camirand M, Leblanc J, Tardif S. Patients' expectations and solutions for improving primary diabetes care. Int J Health Care Qual Assur. 2017;30(6):554-567. doi:10.1108/IJHCQA-07-2016-0106
• 18. Zhao W, Chen JJ, Perkins R, Liu Z, Ge W, Ding Y, Zou W. A heuristic approach to determine an appropriate number of topics in topic modeling. BMC Bioinformatics. 2015;16(Suppl 13):S8. doi:10.1186/1471-2105-16-S13-S8
• 19. Lacey H, Jain N, Sugimoto M, et al. Advancing diabetes primary care education and knowledge in Nepal: A scoping review and case study discussion. Prim Care Diabetes. 2024;18(2024):25-36. doi:10.1016/j.pcd.2023.11.012
• 20. CDC. FastStats - Physician office visits. Center for Disease Control and Prevention. Published 2019. Available at: https://www.cdc.gov/nchs/fastats/physician-visits.htm. Accessed October 14, 2024
• 21. Rowley WR, Bezold C, Arikan Y, Byrne E, Krohe S. Diabetes 2030: Insights from Yesterday, Today, and Future Trends. Popul Health Manag. 2017;20(1):6-12. doi:10.1089/pop.2015.0181
• 22. Peter P, Lipska KJ. The rising cost of diabetes care in the USA. Lancet Diabetes Endo. 2016;4(6):479-480. doi:10.1016/S2213-8587(15)00519-7
• 23. Nath B, Gupta SD, Kumari R. Effect of comorbidities on direct cost among type 2 diabetes mellitus (T2DM) patients in tertiary care government hospital in Uttarakhand, India: A primary data analysis of out of pocket expenditure. Diab Met Synd Clin R. 2020;14(6):2153-2159. doi:10.1016/j.dsx.2020.11.009
• 24. Kapur A, Schmidt MI, Barceló A. Diabetes in Socioeconomically Vulnerable Populations. J Endocrinol. 2015;2015:1-2. doi:10.1155/2015/247636
• 25. Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: Epidemiologic evidence. Physiol Behav. 2010;100(1):47-54. doi:10.1016/j.physbeh.2010.01.036
• 26. Wangler J, Jansky M. Attitudes to and experience of disease management programs in primary care—an exploratory survey of general practitioners in Germany. Wien Med Wochenschr. 2021;171(13-14):310-320. doi:10.1007/s10354-021-00867-1
• 27. Kim S. Effect of primary care-level chronic disease management policy on self-management of patients with hypertension and diabetes in Korea. Prim Care Diabetes. 2022;16(5):677-683. doi:10.1016/j.pcd.2022.08.003
• 28. Dagenais GR, Gerstein HC, Zhang X, et al. Variations in Diabetes Prevalence in Low-, Middle-, and High-Income Countries: Results from the Prospective Urban and Rural Epidemiological Study. Diabetes Care. 2016;39(5):780-787. doi:10.2337/dc15-2338
• 29. Gorham G, Asanga Abeyaratne, Heard S, et al. Developing an integrated clinical decision support system for the early identification and management of kidney disease—building cross-sectoral partnerships. Bmc Med Inform Decis. 2024;24(69):1-10. doi:10.1186/s12911-024-02471-w
• 30. Reach G, Pechtner V, Gentilella R, Corcos A, Ceriello A. Clinical inertia and its impact on treatment intensification in people with type 2 diabetes mellitus. Diabetes Metab. 2017;43(6):501-511. doi:10.1016/j.diabet.2017.06.003
• 31. Kerr EA, Heisler M, Krein SL, et al. Beyond Comorbidity Counts: How Do Comorbidity Type and Severity Influence Diabetes Patients’ Treatment Priorities and Self-Management? J Gen Intern Med. 2007;22(12):1635-1640. doi:10.1007/s11606-007-0313-2
• 32. Moosaie F, Ghaemi F, Mechanick JI, et al. Obesity and Diabetic Complications: A Study from the Nationwide Diabetes Report of the National Program for Prevention and Control of Diabetes (NPPCD-2021) Implications for Action on Multiple Scales. Prim Care Diabetes. 2022;16(3):422-429. doi:10.1016/j.pcd.2022.03.009
• 33. Deshpande AD, Harris Hayes M, Schootman M. Epidemiology of Diabetes and Diabetes-Related Complications. Phys Ther. 2018;88(11):1254-1264. doi:10.2522/ptj.20080020
• 34. Farmaki P, Damaskos C, Garmpis N, Garmpi A, Savvanis S, Diamantis E. Complications of the Type 2 Diabetes Mellitus. Curr Cardiol Rev. 2020;16(4):249-251. doi:10.2174/1573403x1604201229115531
• 35. Armstrong DG, Boulton AJM, Bus SA. Diabetic Foot Ulcers and Their Recurrence. New Engl J Med. 2017;376(24):2367-2375. doi:10.1056/nejmra1615439
• 36. Fesseha BK, Abularrage CJ, Hines KF, et al. Association of Hemoglobin A1c and Wound Healing in Diabetic Foot Ulcers. Diabetes Care. 2018;41(7):1478-1485. doi:10.2337/dc17-1683
• 37. Wilkinson Berka JL, Miller AG. Update on the Treatment of Diabetic Retinopathy. Sci World J. 2008;8:98-120. doi:10.1100/tsw.2008.25
• 38. Umanath K, Lewis JB. Update on Diabetic Nephropathy: Core Curriculum 2018. Am J Kidney Dis. 2018;71(6):884-895. doi:10.1053/j.ajkd.2017.10.026
• 39. Lehmann HC, Wunderlich G, Fink GR, Sommer C. Diagnosis of peripheral neuropathy. Neurol Res Pract. 2020;2:1-7. doi:10.1186/s42466-020-00064-2
• 40. Wang X, Yuan CX, Xu B, Yu Z. Diabetic foot ulcers: Classification, risk factors and management. World J Diabetes. 2022;13(12):1049. doi:10.4239/wjd.v13.i12.1049
• 41. McGill M, Blonde L, Chan JCN, Khunti K, Lavalle FJ, Bailey CJ. The Interdisciplinary Team in Type 2 Diabetes management: Challenges and Best Practice Solutions from real-world Scenarios. J Clin Transl Endocr. 2017;7(7):21-27. doi:10.1016/j.jcte.2016.12.001
• 42. McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational Diabetes Mellitus. Nat Rev Dis Primers. 2019;5(47):1-19. doi:10.1038/s41572-019-0098-8
• 43. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379(9833):2279-2290. doi:10.1016/s0140-6736(12)60283-9
• 44. Geiss LS, James C, Gregg EW, Albright A, Williamson DF, Cowie CC. Diabetes Risk Reduction Behaviors Among U.S. Adults with Prediabetes. Am J Prev Med. 2010;38(4):403-409. doi:10.1016/j.amepre.2009.12.029
• 45. Holt RIG, DeVries JH, Hess Fischl A, et al. The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2021;64(12):2609-2652. doi:10.1007/s00125-021-05568-3
• 46. Peric S, Stulnig TM. Diabetes and COVID-19. Wien Klin Wochenschr. 2020;132(13-14):356-361. doi:10.1007/s00508-020-01672-3
• 47. Gottesman BL, Yu J, Tanaka C, Longhurst CA, Kim JJ. Incidence of new-onset type 1 diabetes among US children during the COVID-19 global pandemic. Jama Pediatr. 2022;176(4):414-415. doi:10.1001/jamapediatrics.2021.5801
• 48. American Diabetes Association. 3. Prevention or Delay of Type 2 Diabetes and Associated Comorbidities: Standards of Medical Care in Diabetes—2022. Diabetes Care. 2021;45(Supplement_1):39-45. doi:10.2337/dc22-s003
• 49. Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022;18(9):525-539. doi:10.1038/s41574-022-00690-7
• 50. Kurevija T, Šojat D, Bosnić Z, Mujaj B, Varžić SC, Majnarić Trtica LM. The Reasons for the Low Uptake of New Antidiabetic Drugs with Cardiovascular Effects—A Family Doctor Perspective. J Clin Med. 2024;13(6):1617. doi:10.3390/jcm13061617