Life Beyond Blood Sugar: Biopsychosocial and Economic Perspectives on Living with Diabetes Type 2: A call for Rethinking Diabetic Care in Tanzania

Background Type 2 diabetes (T2D) is an escalating public health challenge in Tanzania, yet little is known about how patients experience and manage the condition beyond biomedical indicators. This study explored the Biopsychosocial and economic dimensions of living with T2D to inform more person-centred diabetes care within Tanzania’s evolving NCD strategy. Methods A qualitative phenomenological study was conducted between January and June 2025 at Benjamin Mkapa Hospital and Dodoma Regional Referral Hospital in central Tanzania. Forty adults with T2D (≥ 6 months post-diagnosis) participated in in-depth, face-to-face interviews conducted in Swahili. Data were audio-recorded, transcribed, and thematically analyzed following Braun and Clarke’s (2006) six-step framework, supported by NVivo 12 (QSR International). Credibility and trustworthiness were enhanced through member checking, reflexivity, and independent coding. Ethical approval was obtained from the University of Dodoma Institutional Research Ethics Committee. Results Five interrelated themes and 17 subthemes captured the lived experience of diabetes: emotional and psychological impact, physical health impact, social and family impact, economic impact, and coping and adaptation. Diagnosis was initially marked by shock, fear, and disbelief, evolving into acceptance and emotional recovery often supported by faith and family relationships. Common physical manifestations included fatigue, weight loss, blurred vision, and infections, while family support emerged as crucial for dietary control and motivation. Financial strain from medication, diet, and transport costs deepened economic vulnerability, particularly among informal workers. Despite these challenges, participants demonstrated resilience and adaptive coping through lifestyle modification, spirituality, and social networks. Conclusion Living with T2D in Tanzania extends far beyond glycemic control, representing a Biopsychosocial and economic journey negotiated within family, faith, and resource constraints. Integrating psychosocial counselling, family-centred education, and financial protection into diabetes services could strengthen adherence and quality of life. These findings support a shift toward holistic, person- and family-centred care within Tanzania’s national NCD response.