INS and diabetes mellitus: • Lack of patients' knowledge and self-management behaviors. • Scarcity of financial and human resources for health. • Community or cultural barriers, such as the recent shift to diets high in carbohydrates and sugar. • Major gaps remain in the provision of services for diabetes. • Financial barriers continue to prevent some patients from receiving regular treatment, including checkups and medication especially for patients requiring insulin. • Failure in adapting guidelines to the Nepali context.