Living with diabetes has its challenges, but for people in rural areas, managing the condition can feel almost impossible. Throughout a recent online open dialogue that I had with other diabetes advocates, one thing became clear: managing diabetes in rural communities is filled with barriers. From limited access to insulin to misdiagnosis and financial constraints, the hurdles are real—and often life-threatening.
In many places, even receiving a basic diabetes diagnosis is difficult. Sometimes, people are not diagnosed until diabetes-related complications like diabetic ketoacidosis (DKA) or vision loss appear. I’ve heard stories of families travelling for hours to reach the nearest hospital, and of people relying on traditional remedies out of desperation or misinformation. It broke my heart—and it lit a fire in me too.
What struck me most was how many of these challenges are entirely preventable. With earlier screening, trained healthcare professionals and regular access to insulin and test strips, we could save lives.
Even receiving a basic diabetes diagnosis is difficult. Sometimes, people are not diagnosed until diabetes-related complications like DKA or vision loss appear
One central theme of the discussion around rural diabetes advocacy was the sheer lack of diabetes education—both for people living with the condition and for healthcare professionals. We also shared stories of how little we were told at diagnosis, and how confusion and fear took over as a result.
Some participants had been misdiagnosed altogether, even treated with the wrong medication. Others talked about how they used to be unaware that children could develop type 2 diabetes. One person said it best: “Education is our most powerful arsenal.”
This hit home for me. I remembered the fog I experienced after my own diagnosis, and how it was only through peer support and self-research that I really began to understand my condition. We should not have to piece together lifesaving knowledge on our own. Education, especially in rural areas, needs to be clear, accessible and ongoing.
It was only through peer support and self-research that I really began to understand my condition. We should not have to piece together lifesaving knowledge on our own
Another topic we touched upon was the weight of stigma. It’s heavy, especially in places where diabetes is poorly understood. I heard stories of children hiding their insulin pens at school, of families keeping diagnoses secret out of shame, and even of people being accused of “injecting drugs” when taking insulin in public.
Young girls seem to face the brunt of it. They are sometimes told to hide their diagnosis before marriage or face rejection by their in-laws. These cultural attitudes aren’t just outdated; they’re dangerous. They lead to delayed care, non-compliance and devastating complications.
It reminded me why awareness campaigns are so important to rural diabetes advocacy. We need to normalise talking about diabetes, injecting in public, and asking for help. Campaigns like #InjectAnywhere, a daring and sensitive awareness campaign launched by Empower T1D in India to overcome the stigma surrounding insulin injection in public spaces, can make a difference, especially when led by people with lived experience.
Young girls seem to face the brunt of it. They are sometimes told to hide their diagnosis before marriage
Hearing others speak made the urban-rural divide feel even more real. In cities, people might have access to specialists, diabetes educators, newer insulins and continuous glucose monitors. But in rural areas? It’s a different story.
Some people shared how they’ve never seen an endocrinologist. Others mentioned that the only insulin available was outdated or incorrectly prescribed. Others noted that hospitals are far away and that even reaching them means losing a day’s wages or more.
This divide can feel overwhelming, but it also made me realise how much power lies in local solutions.
Despite the challenges, what inspired me most were the stories of grassroots action. People shared how they were working with community health workers, schoolteachers, traditional leaders and local NGOs to raise awareness and offer support.
In some places, advocates are training village health workers to recognise the symptoms of type 1 diabetes. In others, peer support groups are popping up in WhatsApp chats and community centres. One participant even started a mobile clinic to take education and care directly to remote areas.
I found myself thinking, “This is how we change things.” Not just from the top down, but from the ground up—with lived experience, empathy and action.
This divide can feel overwhelming, but it also made me realise how much power lies in local solutions
One exciting thing we talked about was how technology and peer support can bridge the gap when traditional systems fall short. From social media advocacy to telemedicine, people are finding creative ways to reach those who would otherwise be left behind.
A few participants had launched social media campaigns, creating content to debunk myths and show what life with diabetes is really like. Others mentioned online education tools, peer mentoring and using platforms like WhatsApp to build local networks.
It made me realise that even when resources are scarce, connection is powerful. And when you combine that connection with information, you’ve got something unstoppable.
Every big change often starts with a simple question. Imagine a child in a small village, recently told they have type 1 diabetes. Instead of waiting days or weeks for help from a doctor far away, what if guidance and support were already available in their own community from someone who truly understood what they were going through?
In June this year, in Maharashtra, India, UDAAN, an NGO that supports children with type 1 diabetes, launched TARA (Type 1 Diabetes Advocacy for Rural Awareness) – a first-of-its-kind rural initiative inspired by the International Diabetes Federation’s Young Leaders in Diabetes programme.
This grassroots model transforms young people living with type 1 diabetes into local health advocates, bridging the gap between awareness and action, diagnosis and dignity. Over three days, 31 youth from 12 regions came together for training in self-expression, communication, ethics, documentation and advocacy.
Each participant received a TARA toolkit and developed local-language posters that addressed misconceptions about diabetes and explained the early symptoms of type 1 diabetes. These posters are now displayed in schools, clinics, pharmacies and village offices. The aim is simple yet powerful: to ensure that no one is left behind and that leadership rooted in lived experience flourishes in every community.
This grassroots model transforms young people living with type 1 diabetes into local health advocates
By the end of our discussion, we had a clearer picture of what’s needed to improve rural diabetes care, and what we can do as diabetes advocates. Here are my takeaways:
Being part of this open dialogue reminded me that rural diabetes advocacy isn’t just a topic for reports or conferences—it’s real, it’s urgent, and it’s deeply human.
It’s about children who go undiagnosed. Parents who can’t afford insulin. Young adults who feel ashamed of their condition. And communities that are doing their best with what little they have.
But it’s also about resilience. About advocates rising up, sharing their stories, and refusing to let diabetes win.
Open Dialogues are a series of online Advocacy Academy sessions from the International Diabetes Federation (IDF). Designed as a space for exchange and learning, the series brings together IDF Members, Blue Circle Voices and Young Leaders in Diabetes. Participants have the opportunity to share experiences, explore pressing topics that affect the diabetes community and beyond, and strengthen their skills as advocates for change.
