Innovative Pharmacist Roles in Diabetes Management: Global Evidence and Lessons from a Community-Based Intervention in Conflict-Affected Sudan

Abstract

Diabetes remains a major global health challenge, with persistent gaps in glycemic control that are especially evident in low resource and conflict affected settings. Pharmacists-trusted, accessible, and medication focused professionals-are increasingly recognized for their capacity to strengthen diabetes prevention and management. This hybrid review and community based study synthesize global evidence with findings from Al Kadaro in Sudan to identify scalable strategies for improving outcomes and advancing health equity. Quantitative and qualitative data from Al Kadaro were integrated with a narrative review of correlated literature, emphasizing pharmacist led care models, digital health integration, culturally tailored education, and system level barriers. Pharmacist delivered interventions consistently demonstrated clinically meaningful HbA1c reductions, improved adherence, and enhanced self management, while community screening revealed a substantial burden of undiagnosed dysglycemia. Culturally adapted education improved patient understanding, and digital tools-including continuous glucose monitoring, mobile health applications, and tele pharmacy-expanded access and continuity of care in unstable environments. Persistent barriers included restrictive regulations, limited reimbursement, workforce shortages, and digital inequities. The findings highlight the need to expand pharmacist led community screening and culturally tailored education, strengthen the integration of digital health tools into routine pharmacy practice, and pursue regulatory and reimbursement reforms that enable pharmacists to deliver innovative, patient centered diabetes care. Collectively, the evidence underscores the transformative potential of pharmacist led models in fragile health systems and their significant role in advancing equitable, technology enabled diabetes management.