Neftaly Management of Diabetes in Primary Care

Empowering Providers. Supporting Patients. Controlling Diabetes Where It Starts.

Diabetes is a growing public health challenge affecting millions worldwide. As the frontline of healthcare delivery, primary care settings play a vital role in the early detection, continuous management, and long-term control of diabetes.

At Neftaly, our Management of Diabetes in Primary Care program equips healthcare professionals with the tools, knowledge, and systems to deliver effective, holistic, and patient-centered diabetes care—right where patients need it most.

Our Mission

To improve diabetes outcomes through comprehensive, integrated management strategies within primary care—focusing on prevention, early diagnosis, treatment optimization, and patient empowerment.

Key Objectives

• Ensure early detection and accurate diagnosis of Type 1, Type 2, and gestational diabetes
• Promote individualized, evidence-based treatment and lifestyle support
• Prevent and manage diabetes-related complications
• Enhance provider skills and capacity in chronic disease management
• Strengthen patient education and self-care practices

Neftaly’s Core Components of Diabetes Management in Primary Care

1. Early Identification and Screening

• Routine screening for at-risk populations (obesity, hypertension, family history, etc.)
• Use of fasting glucose, HbA1c, and oral glucose tolerance tests
• Opportunistic screening during routine visits or community outreach

2. Individualized Treatment Plans

• Lifestyle interventions: diet, physical activity, weight management
• Pharmacologic therapy initiation and titration (oral agents, insulin, etc.)
• Culturally tailored care plans that consider socioeconomic and personal factors
• Management of comorbidities: hypertension, dyslipidemia, cardiovascular risk

3. Patient Education and Self-Management Support

• Diabetes self-management education (DSME) for patients and families
• Training on blood glucose monitoring and insulin use
• Guidance on nutrition, physical activity, and foot care
• Addressing psychosocial aspects, including stress, depression, and stigma

4. Monitoring and Follow-Up

• Regular HbA1c monitoring (every 3–6 months)
• Annual screening for retinopathy, nephropathy, and neuropathy
• Foot examinations and cardiovascular risk assessments
• Ongoing medication review and adjustment

5. Provider Training and Capacity Building

• Clinical training for doctors, nurses, and allied health professionals
• Standardized treatment protocols and decision-support tools
• Workshops on communication, motivational interviewing, and care coordination
• Use of telehealth and digital tools for remote monitoring and follow-up

6. System Integration and Continuity of Care

• Strengthen referral pathways to specialists when needed
• Coordinate care across disciplines (nutrition, pharmacy, mental health)
• Engage community health workers to support adherence and follow-up
• Use of electronic health records (EHRs) to track patient progress and outcomes

Why Neftaly?

• Evidence-based and WHO-aligned protocols
• Tailored for resource-limited and high-burden primary care settings
• Multidisciplinary approach for comprehensive care
• Culturally responsive and patient-centered philosophy
• Focus on sustainability through provider education and community engagement

Better Diabetes Control Starts with Primary Care

With the right support, primary care providers can be powerful agents in preventing complications, improving quality of life, and reducing the burden of diabetes. Neftaly is here to partner with clinics, healthcare workers, and communities to make that vision a reality.