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Diabetes self-care adherence prevalence is 47% among patients with diabetes mellitus in PakistanDiabetes Self-Care Adherence Low in Pakistan

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Key Takeaway
Note that medication adherence is higher than physical activity adherence among Pakistani patients with diabetes.

This meta-analysis synthesized data from 65 studies to evaluate the prevalence of self-care behaviors among patients with diabetes mellitus in Pakistan. The analysis focused on overall self-care, medication adherence, and physical activity adherence. The authors noted substantial statistical heterogeneity across most pooled analyses as a primary limitation of the data.

Key findings include an overall self-care adherence prevalence of 47% (95% CI: 29%-66%) and a mean standardized score of 53.6% (95% CI: 47.8%-59.4%). Medication adherence was reported at a prevalence of 74% (95% CI: 63%-83%). Physical activity adherence was lower, with a reported prevalence of 37% (95% CI: 29%-46%). A statistically significant association (p = 0.02) was found between publication year and physical activity adherence prevalence.

The results highlight significant gaps in lifestyle modification. The authors suggest that these findings underscore the necessity for culturally appropriate interventions to support patients in managing their condition through both lifestyle modifications and pharmacological management. Clinical application should be interpreted with caution due to the reported heterogeneity in the included studies.

A new analysis of 65 studies from Pakistan found that fewer than half of adults with diabetes follow recommended self-care routines. The overall adherence rate was 47%, meaning that on average, less than half of people with diabetes in Pakistan are managing their condition as advised. This matters because good self-care, including diet, exercise, and medication, is key to controlling blood sugar and preventing complications.

The analysis, which pooled data from thousands of patients, also looked at specific behaviors. Medication adherence was relatively higher, with 74% of people taking their medicines as prescribed. However, physical activity adherence was much lower, at only 37%. This suggests that while taking medication is common, staying active is a bigger challenge.

The study also found that physical activity adherence has been changing over time, but the reasons are not clear. The researchers noted that there was a lot of variation among the studies, which means the results should be interpreted with caution.

For readers, this highlights a real-world gap in diabetes care in Pakistan. It suggests that efforts to improve diabetes management may need to focus more on helping people become more physically active and adopt other lifestyle changes. However, this is a summary of existing research, not a new experiment, so it cannot prove what causes low adherence. If you have diabetes, talk to your doctor about realistic ways to improve your self-care routine.

What this means for you:
Many Pakistani adults with diabetes struggle with self-care, especially physical activity, but medication adherence is higher.

Common questions

What is diabetes self-care?

Diabetes self-care includes daily habits like taking medication, eating healthy, being physically active, and checking blood sugar. This study looked at how often people with diabetes in Pakistan follow these behaviors. Overall, only 47% did, which means many are missing out on important steps to manage their condition.

How many people with diabetes in Pakistan take their medication?

According to this analysis, 74% of people with diabetes in Pakistan take their medication as prescribed. That is higher than other self-care behaviors. But it also means about one in four do not, which could lead to poor blood sugar control and complications.

Why is physical activity adherence so low?

Only 37% of people with diabetes in Pakistan meet physical activity recommendations. The study did not investigate reasons, but it suggests that promoting exercise may be a key area for improvement. If you have diabetes, talk to your doctor about safe ways to increase your activity level.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Diabetes mellitus is a major public health challenge in Pakistan. Effective management depends on adherence to self-care behaviors, yet current evidence is fragmented. This systematic review and meta-analysis synthesize evidence on adherence to diabetes self-care behaviors among Pakistani patients. PubMed, Embase, Web of Science, Scopus, Google Scholar, and PakMediNet were systematically searched up to August 2025. Observational studies assessing diabetes self-care were included. Prevalence estimates and standardized mean scores (0-100scale) were pooled. Meta-regression and publication bias analyses were conducted. Sixty-five studies (2003-2025) were included. Overall self-care pooled prevalence was 47% (95% CI: 29%-66%), with a mean standardized score of 53.6% (95% CI: 47.8%-59.4%). Medication adherence was highest (prevalence: 74%, 95% CI: 63%-83%; score: 72.7%). Physical activity showed the poorest adherence (prevalence: 37%, 95% CI: 29%-46%; score: 45.5%). Publication year was significantly associated with physical activity adherence prevalence (p = 0.02). Statistical heterogeneity was substantial across most pooled analyses, indicating considerable variability between studies. Diabetes self-care behaviors in Pakistan remain suboptimal, especially for lifestyle-related practices. The substantially higher adherence to medication than to physical activity and other self-care behaviors highlights the need for culturally appropriate interventions that strengthen lifestyle modification alongside pharmacological management.
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