Symbolic illustration of diabetes care challenges and opportunities in India.

Diabetes Dilemma: Can Empowering Primary Care Tame India's Rising Tide?

Lena Voss in Health & Wellness November 2025 • 5 min read.

"A Case Study Exploring Health-Seeking Behavior and the Need for Stronger Primary Healthcare in Diabetes Management"

Diabetes mellitus is a global health challenge, and its rise in developing countries is particularly alarming. India, home to a significant portion of the world's diabetic population, faces a daunting task in managing this chronic disease. Effective management requires a multi-faceted approach, with a robust primary healthcare system at its core.

This article delves into a compelling case study that highlights the intricacies of diabetes care in India. It examines the health-seeking behavior of a patient navigating the healthcare system, revealing the gaps and opportunities for improvement. By understanding the patient's journey, we can gain valuable insights into strengthening primary healthcare and improving diabetes outcomes.

This case study focuses on Mrs. SM, a patient receiving treatment at the Non-Communicable Diseases (NCD) Prevention Clinic at the All India Institute of Medical Sciences (AIIMS), Bhubaneswar. Her journey underscores the challenges faced by many individuals in accessing and adhering to diabetes care, shedding light on the critical need for a more empowered and accessible primary healthcare system.

Unpacking the Patient's Journey: A Look at Health-Seeking Behavior

Symbolic illustration of diabetes care challenges and opportunities in India.

Mrs. SM's story begins in a rural part of Odisha, India. After experiencing symptoms, she consulted a local practitioner and was eventually referred to a tertiary care facility, SCB Medical College, for a diagnosis of type 2 diabetes and hypertension. This initial referral highlights a common issue: the burden on tertiary centers for initial diagnoses that could potentially be managed at the primary care level.

Following her diagnosis, Mrs. SM's treatment path included insulin therapy, oral medications, and care at both the tertiary center and a Primary Health Centre (PHC). Ultimately, she began attending the NCD Prevention Clinic at AIIMS, traveling a significant distance to receive care. Her dedication to treatment despite financial constraints raises critical questions about the factors influencing her health-seeking behavior.

Perceived Susceptibility: Mrs. SM believes that failing to manage her diabetes and hypertension could increase her risk of serious complications like cancer and heart disease.
Perceived Severity: She recognizes diabetes as a long-term illness that can lead to complications if left untreated.
Perceived Benefits: Mrs. SM believes that timely clinic visits and consistent treatment will improve her overall health and enable her to care for her family.
Perceived Barriers: Cost of transport and treatment and distance to healthcare facility is the biggest challenge.
Cues to Action: She got information from the village about preventive and curative measures for diabetes.
Self-Efficacy: With treatment and support from family, she can visit more often.

Analyzing Mrs. SM's journey through the lens of the Health Belief Model provides valuable insights. This model suggests that health behaviors are influenced by an individual's perception of their susceptibility to a disease, the severity of the disease, the benefits of taking action, and the barriers to doing so. In Mrs. SM's case, her belief in the severity of diabetes and the benefits of treatment, coupled with cues to action from her community and a sense of self-efficacy, have driven her to seek care despite the challenges.

Empowering Primary Care: A Path Forward

Mrs. SM's case underscores the urgent need to strengthen primary healthcare systems to effectively manage the growing burden of diabetes and other chronic diseases. By empowering primary care physicians with the resources, training, and support they need, we can improve access to care, promote early diagnosis, and reduce the strain on tertiary care facilities. Investing in community-based awareness programs and family-centered approaches will also be crucial in fostering a culture of prevention and self-management. Only through a concerted effort can we hope to turn the tide against the diabetes epidemic and build a healthier future for all.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s13410-018-0666-6, Alternate LINK

Title: Management Of Diabetes Mellitus: Need For Empowering Primary Health Care

Subject: Endocrinology, Diabetes and Metabolism

Journal: International Journal of Diabetes in Developing Countries

Publisher: Springer Science and Business Media LLC

Authors: Sarika Palepu, Binod Kumar Patro

Published: 2018-07-06

Everything You Need To Know

According to the Health Belief Model, what specific factors influenced Mrs. SM's decision to seek and continue diabetes treatment, and what crucial element is missing from understanding her lifestyle changes?

Mrs. SM's health-seeking behavior is significantly influenced by several factors outlined in the Health Belief Model. Her belief that failing to manage her diabetes and hypertension increases her risk of complications indicates high perceived susceptibility. Recognizing diabetes as a long-term illness reflects perceived severity. She also believes timely clinic visits and treatment will improve her health, demonstrating perceived benefits. However, the cost of transport and distance act as perceived barriers. Information from her village serves as cues to action, and with family support, she feels self-efficacious in managing her condition. A missing element not explicitly detailed is her understanding of the specific lifestyle changes needed, such as dietary modifications and exercise, and how these integrate into her daily life, impacting her ability to consistently manage the condition.

What specific steps are involved in empowering primary care physicians to manage diabetes more effectively, and how can this decentralization reduce the strain on tertiary care facilities?

Empowering primary care physicians involves equipping them with the necessary resources, training, and support to manage chronic diseases like diabetes effectively. This includes providing them with diagnostic tools, treatment guidelines, and ongoing education to stay updated with the latest advancements in diabetes care. Additionally, it involves integrating primary care with community-based awareness programs and family-centered approaches to foster a culture of prevention and self-management. By decentralizing diabetes management, the burden on tertiary care facilities like AIIMS, Bhubaneswar, can be reduced, making healthcare more accessible to patients like Mrs. SM. What isn't mentioned is the integration of technology in primary care to enhance remote monitoring and consultation capabilities, which can further improve accessibility and adherence to treatment.

Following her initial diagnosis, what was Mrs. SM's treatment path, and what crucial aspect of coordination between healthcare providers is not explicitly detailed?

Mrs. SM was initially diagnosed with type 2 diabetes and hypertension at SCB Medical College after being referred by a local practitioner in rural Odisha. She then received treatment that included insulin therapy, oral medications, and care at both the tertiary center and a Primary Health Centre (PHC). She began attending the Non-Communicable Diseases (NCD) Prevention Clinic at AIIMS, Bhubaneswar, traveling a significant distance to receive care. A crucial aspect not detailed is the coordination between these different healthcare providers. For example, how is information shared between the PHC, SCB Medical College, and AIIMS to ensure a cohesive and consistent treatment plan for Mrs. SM?

What key challenges in healthcare access are highlighted in the case study, particularly for individuals in rural areas like Mrs. SM, and what specific cultural and linguistic barriers are not explicitly addressed?

The case study demonstrates several challenges in healthcare access, particularly for individuals in rural areas. These include the distance to healthcare facilities, the financial burden of transport and treatment, and the reliance on tertiary centers for initial diagnoses that could be managed at the primary care level. Mrs. SM's journey highlights the need for a stronger primary healthcare system to address these challenges. What the case study doesn't explicitly address is the cultural and linguistic barriers that may also impact healthcare access and adherence to treatment for individuals like Mrs. SM.

What factors are contributing to India's diabetes crisis, and what broader public health policies are needed beyond primary care to address the social determinants of health influencing diabetes?

India faces a significant diabetes crisis due to the rising prevalence of diabetes mellitus. Factors contributing to this crisis include lifestyle changes, urbanization, and genetic predispositions. Managing diabetes effectively requires a multi-faceted approach, with a robust primary healthcare system at its core. The case study emphasizes the need to empower primary care physicians and improve access to care, particularly in rural areas. What is not emphasized are the broader public health policies and interventions needed to address the social determinants of health, such as food security and access to safe drinking water, which can significantly impact diabetes prevention and management.