Prevalence of type 2 diabetes mellitus (T2DM) has almost doubled in recent decades and commonly presents comorbidities and complications. T2DM is a multisystemic disease, requiring multidisciplinary treatment provided by teams working in a coordinated and collaborative manner. The application of Social Network Analysis techniques in the healthcare domain has allowed researchers to analyze interaction between professionals and their roles inside care teams. We studied whether the structure of care teams, modeled as complex social networks, is associated with patient progression. For this, we illustrate a data-driven methodology and use existing social network analysis metrics and metrics proposed for this research. We analyzed appointment and HbA1c blood test result data from patients treated at three primary health care centers, representing six different practices. Patients with good metabolic control during the analyzed period were treated by teams that were more interactive, collaborative and multidisciplinary, whereas patients with worsening or unstable metabolic control were treated by teams with less collaboration and more continuity breakdowns. Results from the proposed metrics were consistent with previous literature and reveal relevant aspects of collaboration and multidisciplinarity.

Multidisciplinary treatment and continuity of care throughout treatment are important for ensuring metabolic control and avoiding complications in diabetic patients. This study examines the relationship between continuity of care of the treating disciplines and clinical evolution of patients. Data from 1836 adult patients experiencing type 2 diabetes mellitus were analyzed, in a period between 12 and 24 months. Continuity was measured by using four well known indices: Usual Provider Continuity (UPC), Continuity of Care Index (COCI), Herfindahl Index (HI), and Sequential Continuity (SECON). Patients were divided into five segments according to metabolic control: well-controlled, worsened, moderately decompensated, highly decompensated, and improved. Well-controlled patients had higher continuity by physicians according to UPC and HI indices (p-values 0.029 and <0.003), whereas highly decompensated patients had less continuity in HI (p-value 0.020). Continuity for nurses was similar, with a greater continuity among well-controlled patients (p-values 0.015 and 0.001 for UPC and HI indices), and less among highly decompensated patients (p-values 0.004 and <0.001 for UPC and HI indices). Improved patients had greater adherence to the protocol than those who worsened. The SECON index showed no significant differences across the disciplines. This study identified a relationship between physicians and nurse’s continuity of care and metabolic control in patients with diabetes, consistent with qualitative findings that highlight the role of nurses in treatment.