Faisal A, Awais M, Tariq Z, Basit A, Abbas T, Farzeela F, Iftikhar A, Basil AM. Qualitative systematic review of the socioeconomic factors affecting type 2 diabetes management in Pakistan. World J Diabetes 2025; 16(10): 111102 [PMID: 41113483 DOI: 10.4239/wjd.v16.i10.111102]
Corresponding Author of This Article
Abdul M Basil, MD, Department of Medicine, Spinghar Medical University, 4th Alley, Char Rahe Qambar Kabul, Kabul 1001, Kābul, Afghanistan. abdulmaboodbasil@outlook.com
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Endocrinology & Metabolism
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Systematic Reviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 15, 2025 (publication date) through Oct 22, 2025
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World Journal of Diabetes
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1948-9358
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Faisal A, Awais M, Tariq Z, Basit A, Abbas T, Farzeela F, Iftikhar A, Basil AM. Qualitative systematic review of the socioeconomic factors affecting type 2 diabetes management in Pakistan. World J Diabetes 2025; 16(10): 111102 [PMID: 41113483 DOI: 10.4239/wjd.v16.i10.111102]
World J Diabetes. Oct 15, 2025; 16(10): 111102 Published online Oct 15, 2025. doi: 10.4239/wjd.v16.i10.111102
Qualitative systematic review of the socioeconomic factors affecting type 2 diabetes management in Pakistan
Affan Faisal, Muhammad Awais, Zain Tariq, Abdul Basit, Tahleel Abbas, Fnu Farzeela, Abdullah Iftikhar, Abdul M Basil
Affan Faisal, Muhammad Awais, Zain Tariq, Abdul Basit, Tahleel Abbas, Abdullah Iftikhar, Department of Medicine, King Edward Medical University, Lahore 54000, Punjab, Pakistan
Fnu Farzeela, Department of Medicine, People’s University of Medical and Health Sciences, Nawabshah 67450, Sindh, Pakistan
Abdul M Basil, Department of Medicine, Spinghar Medical University, Kabul 1001, Kābul, Afghanistan
Author contributions: Faisal A and Basit A conducted research concepts; Awais M, Tariq Z, and Basit A conducted literature reviews and citation management; Faisal A and Basil AM created the PRISMA flowchart; Faisal A, Tariq Z, Awais M, Abbas T, Iftikhar A, and Farzeela F wrote and reviewed the manuscript; All authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdul M Basil, MD, Department of Medicine, Spinghar Medical University, 4th Alley, Char Rahe Qambar Kabul, Kabul 1001, Kābul, Afghanistan. abdulmaboodbasil@outlook.com
Received: June 23, 2025 Revised: July 19, 2025 Accepted: September 1, 2025 Published online: October 15, 2025 Processing time: 114 Days and 16.5 Hours
Abstract
BACKGROUND
Type 2 diabetes mellitus (T2DM) is increasing rapidly in Pakistan, especially among socioeconomically disadvantaged populations. While clinical care remains central, social determinants such as poverty, gender norms, and mistrust in healthcare critically shape disease outcomes.
AIM
To synthesize qualitative evidence on how these factors influence the experience and management of T2DM in Pakistan.
METHODS
Following PRISMA guidelines, a systematic review of qualitative studies published between 2000 and 2025 was conducted on February 25, 2025 using PubMed, CINAHL, MEDLINE Plus, and PakMediNet. Eleven studies exploring socioeconomic influences on T2DM care and self-management in Pakistan were included. Thematic synthesis was used to identify key patterns. Quality was appraised using the Joanna Briggs Institute Checklist for Qualitative Research.
RESULTS
Three major themes were identified: (1) Economic insecurity. High cost of treatment, poor rural infrastructure, and food insecurity hinder access and adherence; (2) Sociocultural and gender norms. Restricted mobility of females, family control over health decisions, and fatalistic beliefs delay care; and (3) Knowledge gaps and mistrust. A lack of culturally appropriate education, reliance on traditional remedies, and distrust in public health systems reduce compliance. These intersecting barriers collectively impede effective diabetes management.
CONCLUSION
T2DM in Pakistan is driven by entrenched social and economic barriers. Addressing it requires culturally sensitive, equity-oriented strategies that go beyond biomedical models. Policy reforms should focus on affordability, rural outreach, and inclusive health education. Future research should engage marginalized voices through participatory methods.
Core Tip: This article highlighted how socioeconomic and cultural barriers such as poverty, gender norms, and mistrust undermine diabetes care in Pakistan. Economic hardship limits access while sociocultural norms restrict health-seeking behavior, especially among females. Misinformation and distrust further exacerbate poor outcomes. Effective type 2 diabetes mellitus management demands equity-driven, culturally responsive health interventions.
