A mixed-methods online survey conducted in 2024–2025 among designated informants from 86 International Diabetes Federation (IDF) member associations generated 131 responses to evaluate stakeholder perspectives on access to insulin and oral hypoglycemic agents (OHAs). The questionnaire addressed medicine availability, reimbursement mechanisms, affordability, and structural access constraints. Quantitative findings were analyzed descriptively, while open-ended responses underwent thematic analysis. Where multiple responses were received from the same country, all were included to reflect diverse national perspectives. The results were published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

Insulin analogues were reported as available in 68.8% of settings, with full reimbursement in 63.5%. Among OHAs, biguanides and sulfonylureas were most frequently available. Major access barriers identified included high out-of-pocket costs, limited insurance coverage, supply disruptions, and insufficient patient education. Perceived disparities were particularly noted in low- and lower-middle-income settings.

Regional representation was uneven, with over-representation from South and Central America and under-representation from South-East Asia, limiting subgroup comparisons. As a stakeholder-based survey, findings reflect reported perspectives rather than independently verified utilization data.

These results provide a contemporary policy-relevant overview of perceived global inequities in diabetes medicine access. The findings highlight persistent affordability and supply challenges that may affect equitable care delivery across countries.