Abstract: Background　Prediabetes can be delayed or its progression to diabetes prevented through lifestyle interventions; however, the implementation of prediabetes management in primary care remains low. Objective　This study aimed to examine the awareness and current management practices of primary care physicians and nurses regarding prediabetes, identify existing barriers and challenges, and determine key supportive factors to improve management quality. Methods　From January to February 2025, semi-structured interviews were conducted with primary care physicians and nurses at a community health service center in Beijing regarding prediabetes management. The interviews were analyzed using thematic analysis to identify themes, which were subsequently mapped onto the Capability–Opportunity–Motivation Behavior (COM-B) model. Data were coded and analyzed with NVivo 11.0. Results　Fifteen primary care physicians and nurses were interviewed, resulting in eight core themes and fifteen subthemes. The findings revealed that systematic management pathways for prediabetes have not yet been established in China's primary healthcare system. Although healthcare providers generally demonstrated strong professional responsibility and motivation, key barriers included insufficient knowledge and skills, limited policy and incentive support, underdeveloped information systems, workforce shortages, and a lack of multidisciplinary collaboration. Conclusion　Establishing a comprehensive diabetes prevention and control system at the primary care level, integrating performance evaluation frameworks, establishing a dedicated "prediabetes" module and general–specialist collaboration, strengthening training in behavioral interventions for primary care providers, and implementing feedback and incentive mechanisms to boost self-efficacy can collectively promote effective prediabetes management and advance the front line of diabetes prevention.

Key words: Prediabetic state, General practitioners, Nurses, COM-B model, Qualitative study, Primary healthcare institutions

摘要： 背景　糖尿病前期通过生活方式干预可延迟或预防糖尿病发生；然而，糖尿病前期管理在初级保健中的实施率普遍较低。目的　本研究旨在探讨基层全科医护对糖尿病前期的认知与管理现状，分析存在的障碍与挑战，并明确提升管理质量所需的支持因素。方法　2025年1—2月，在北京市某社区卫生服务中心对全科医护进行糖尿病前期管理的半结构化访谈，并进行主题分析以确定主题，随后将其映射到能力、机会、动机-行为模型中，运用NVivo11.0软件进行数据编码与分析。结果　共访谈15名基层全科医护，提取8个核心主题和15个副主题。结果显示，我国基层尚未形成系统的糖尿病前期管理路径；医护普遍具有职业责任意识与管理动机，但知识与技能不足、政策支持与激励机制有限、信息系统功能不完善、基层人力紧张及多学科协作缺乏是主要障碍。结论　通过构建基层糖尿病防控体系及绩效考核体系，完善“糖尿病前期”功能模块与全科-专科协作机制，强化全科医护系统培训与行为干预技能培养，通过反馈与激励机制增强医护的自我效能与管理信心等措施，促进糖尿病前期管理，推动糖尿病防控关口前移。

关键词: 糖尿病前期, 全科医生, 护士, COM-B 模型, 质性研究, 基层医疗卫生机构