A Tanahashi Coverage Cascade Analysis of Diabetes Care in Saudi Arabia (2016–2021): A Narrative Review

Abstract Diabetes affects nearly a quarter of adults in Saudi Arabia (SA) and costs primary healthcare centres around 35 million USD annually. Despite initiatives like the National Diabetes Registry and Vision 2030’s Model of Care, limited evidence exists on the system’s effectiveness. Analysis on publicly available secondary data was done guided by Tanahashi coverage cascade to estimate diabetes care coverage in SA between 2016 and 2021 from the suppliers’ perspective. The manuscript was prepared in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. Findings indicate healthcare resources are available, with densities of 36.6 general practitioners and 18 family physicians per 100,000 population. However, utilisation is low, with only 0.16 annual visits per diabetic in 2020. Accessibility improved with 31 specialised diabetes centres by 2024, although distribution remains uneven, especially in rural and high burden areas. Contact coverage is constrained by very low microalbuminuria screening (2%), whereas eye and foot screenings reach about 60%. Effectiveness coverage is reflected in the calculated weighted mean difference in haemoglobin A1c from the baseline of (9.7%) to (−0.58%) over 5 years of follow up, corresponding to an approximate (6%) relative reduction in glycaemic levels, yet overall control coverage (24%) falls below international standards. Policies should focus on strengthening recall systems, expanding community outreach, integrating risk stratification and embedding diabetes care within universal health coverage (UHC) to ensure equitable, sustainable and value-based care. Hence, advancing progress towards UHC.