DETECTING TO CARE: THE ROLE OF PRIMARY HEALTH CARE IN SCREENING AND EARLY DIAGNOSIS OF DIABETES MELLITUS

Abstract

This chapter discusses screening and early diagnosis of Diabetes Mellitus, with emphasis on type 2 diabetes, in Primary Health Care, highlighting epidemiological foundations, current screening criteria, diagnostic methods, operational challenges, and implications for care organization within the Brazilian Unified Health System. It is a theoretical-analytical chapter based on a narrative review of clinical guidelines, official documents, and recent scientific literature on diabetes epidemiology, prevention, screening, and diagnosis in primary care. The findings indicate that the high prevalence of diabetes in Brazil, combined with the frequency of asymptomatic cases and the risk of preventable chronic complications, reinforces the relevance of early diagnosis. Recent guidelines recommend broader screening, especially for adults aged 35 years or older and for younger individuals with overweight and additional risk factors. Fasting plasma glucose and glycated hemoglobin are the main screening and confirmatory tests, although test selection depends on local diagnostic capacity. However, screening is only effective when early identification is linked to laboratory confirmation, continuity of care, health education, and long-term management. It is concluded that Primary Health Care is the strategic setting for implementing timely and comprehensive care pathways, but success depends on workforce qualification, well-defined care flows, laboratory infrastructure, and sensitivity to social inequalities affecting access to diagnosis and treatment.