BACKGROUND:
Diabetes is a major public health challenge and a leading driver of preventable morbidity and mortality. In conflict-affected settings, disruption of primary care, medication supply chains, laboratory access, and safe follow-up increases the risk of acute events and accelerates complications, demanding models that maintain prevention and continuity of care during system shock.

AIM:
To describe the Diabetes Awareness and Prevention (DAP) initiative in Palestine and share early implementation outputs and lessons for scaling integrated diabetes prevention and care in resource-constrained, unstable contexts.

METHODS:
DAP is a primary-care–led, community-linked programme implemented during war-related disruption. The package comprises: (1) culturally adapted community education on diabetes risk, locally feasible diet and physical activity, medication adherence, hypoglycaemia recognition, and red-flag symptoms; (2) risk-based screening and triage in primary care with referral pathways for high-risk individuals and people with uncontrolled diabetes; (3) structured self-management support (goal setting, home monitoring guidance when feasible, foot care, and sick-day rules); (4) frontline workforce training using brief job aids aligned with WHO essential NCD interventions for low-resource primary care; and (5) pragmatic monitoring using implementation indicators (reach, adoption, fidelity, and barriers/facilitators) to guide iterative improvement.

RESULTS:
Early implementation demonstrated the feasibility of delivering education, counseling, screening/triage, and self-management support through primary care and community channels, despite insecurity and constrained resources. Key lessons included prioritising trust-building and culturally sensitive messaging; using brief, standardised counselling scripts to support fidelity under high workload; adapting delivery modes (small-group sessions, opportunistic counselling, and community outreach) to improve reach; and strengthening partnerships with health authorities and community actors to support continuity of medicines, testing access, and referral follow-up. These insights informed iterative refinement of training content, referral pathways, and monitoring priorities.

CONCLUSIONS:
A primary-care–anchored diabetes prevention and continuity model is feasible during conflict and offers a scalable approach to reduce avoidable complications in polycrisis settings.