Cultural Beliefs and Practices Leading to Delayed Diagnosis and Management of Diabetes in Peshawar

Abstract

In Pakistan, the prevalence of diabetes mellitus has increased from 5.2 million cases in 2000 to almost 33 million by 2021, making it a serious public health concern. With a focus on Pashtun cultural norms, this study investigates the cultural beliefs and practices that lead to delayed diagnosis and inadequate diabetes management in Peshawar, Khyber Pakhtunkhwa region. The analysis shows that timely diagnosis and treatment adherence are hampered by a number of factors, including reliance on traditional healers (hakeems), misconceptions about insulin, stigma surrounding chronic illness, gender-restricted healthcare access, family-dominated decision-making and misinterpretation of religious teachings regarding Ramadan fasting. According to national data, almost 60% of patients in Pakistan do not take their oral antidiabetic drugs as prescribed and two-thirds of adults with type 2 diabetes experience diabetes discomfort. Particularly in Peshawar, more than 50% of diabetes patients have foot ulcers, over 25% have had amputations and 75% think insulin is the last line of therapy. Increased incidence of neuropathy, retinopathy and nephropathy as well as a greater strain on KPK's healthcare system are among the public health repercussions. The study suggests culturally aware, nurse-led interventions such as family-centred teaching in Pashto, community screening initiatives and cooperation with local jirgas and religious leaders.

Keywords: Peshawar, Pashtun Culture, Diabetes Mellitus, Cultural Beliefs, Delayed Diagnosis, Nursing Interventions, Pakistan