The British Journal of General Practice · Jun 2, 2026

Equity and impact of social prescribing in type 2 diabetes prevention: cross-sectional and cohort study using national primary care data

By Calderón-Larrañaga S, Meza-Torres B, de Lusignan S et al.

BACKGROUND: Social prescribing has expanded rapidly in English primary care since 2019 to support the prevention and management of long-term conditions. However, evidence on its equity of access and effectiveness for type 2 diabetes (T2D) prevention is limited. AIM: To examine the reach, equity of access, and potential impact of social prescribing on T2D prevention among adults at high risk. DESIGN AND SETTING: Observational study using routinely collected data from the Oxford-RCGP Research and Surveillance Centre, including >1800 general practices in England (January 2019 to November 2023). METHOD: Cross-sectional analyses using multivariable logistic regression examined factors associated with social prescribing referral among adults at high risk of T2D. Cohort analyses estimated the association between social prescribing referral and incident T2D, adjusting for baseline covariates. Calendar-period-stratified Cox models were used to capture programme roll-out and COVID-19 changes. Exploratory time-since-index analyses tested if effects varied over time. RESULTS: Among 2 326 400 adults at high-risk of T2D, 271 582 (11.7%) developed T2D over a median 3.7 years (interquartile range [IQR] 1.44-4.83). Referrals to social prescribing increased 9.5-fold from 0.3% (n = 3897/1 479 172) in 2019-2020 to 2.5% (n = 47 883/1 917 187) in January-November 2023, and were more common among women (adjusted odds ratio (aOR) 1.42, 95% confidence interval [CI] = 1.40 to 1.43), those living in more deprived areas (aOR 1.89, 95% CI = 1.86 to 1.93), current smokers (aOR 1.71, 95% CI = 1.68 to 1.73), people with obesity (aOR 1.19, 95% CI = 1.17 to 1.21), depression/anxiety (aOR 2.52, 95% CI = 2.49 to 2.54), and multimorbidity (aOR 1.45, 95% CI = 1.43 to 1.47). By calendar year, social prescribing was associated with an increased risk of T2D in 2019 (adjusted hazard ratio [aHR] 1.67, 95% CI = 1.20 to 2.32) but became protective by 2023 (aHR 0.84, 95% CI = 0.79 to 0.89). By follow-up, social prescribing was associated with an increased risk of T2D within 0-2 years post-referral (aHR 1.09, 95% CI = 1.04 to 1.15) but was protective after ≥3 years (aHR 0.88, 95% CI = 0.80 to 0.97). CONCLUSION: Social prescribing reached those with greater health and social need. The protective association against T2D emerged as services matured post-COVID-19 and with longer follow-up, potentially reflecting cumulative engagement, although activity data were unavailable.

doi.org/10.3399/bjgp.2025.0748 Open access PubMed 42225389 Interventions