Type 2 diabetes, a prevalent chronic disease, imposes a substantial burden on individuals and societies worldwide, resulting in multifaceted health, social, and economic costs. The prevalence of type 2 diabetes has reached pandemic proportions, with an estimated global prevalence of 9.3% in 2019, affecting over 463 million people, and is projected to rise to 10.9% by 2045 [1]. The health-related consequences of type 2 diabetes encompass a range of complications, including cardiovascular disease, neuropathy, nephropathy, and retinopathy, all of which contribute to reduced quality of life and increased mortality rates [1].

Beyond the direct health impact, type 2 diabetes exerts substantial social and economic costs [2, 3]. It necessitates ongoing medical care, including medication and monitoring, straining healthcare systems and increasing healthcare expenditures [2]. Furthermore, individuals with type 2 diabetes often experience reduced productivity and missed workdays due to illness and medical appointments, affecting their economic wellbeing and placing a financial burden on society [3].

The preventable nature of type 2 diabetes underscores the pivotal role of patient involvement in effective diabetes prevention strategies [1, 4]. Recent research has demonstrated that lifestyle modifications, including dietary improvements, increased physical activity, and weight management, can significantly reduce the risk of developing type 2 diabetes among high-risk individuals [4, 5]. These interventions necessitate active patient engagement, demanding sustained behavioral changes and adherence to health-promoting practices. Patient involvement extends beyond mere compliance with medical recommendations; it encompasses education, empowerment, and self-management skills, all of which are integral to the success of diabetes prevention efforts [6]. Encouraging individuals to take an active role in their health and providing them with the necessary tools and support to make informed decisions and sustain healthy lifestyles are paramount in the fight against type 2 diabetes.

There is an increasing recognition of the need to take measures to reduce the risk, detect early, and limit the consequences of type 2 diabetes. Diabetes prevention has become a priority at the global [7], regional [8], and national levels.

In Poland, central and local authorities are taking action to prevent diabetes under The National Health Programme 2021–2025 [9]. Nonetheless, type 2 diabetes prevalence in Poland is on the rise [10]. It is estimated that the number of patients diagnosed with diabetes exceeds 2.5 million [11], and up to a million are unaware of the diagnosis [12].

Preventing type 2 diabetes involves two main strategies: primary and secondary prevention. Primary prevention aims to reduce the occurrence and progression of the condition in individuals without diabetes who are at risk due to factors such as obesity, physical inactivity, and poor dietary habits [13]. Lifestyle modification programs are crucial in primary prevention, focusing on behavioural changes like healthy eating, regular exercise, and weight management to lower the risk of developing type 2 diabetes [14]. Secondary prevention involves early detection of the disease in seemingly healthy individuals who have subclinical forms of diabetes. Secondary prevention strategies often involve targeted [15] or opportunistic [16] screening (mainly blood sugar testing) and advice or counselling provided by medical professionals (i.e., brief intervention) [17].

Barriers to effective preventive actions include organizational issues such as administrative or financial limitations [18, 19], as well as participants’ dependent factors that limit attendance in offered activities [20, 21]. The importance of determining the scope/method of intervention following participant expectations and capabilities [22] and selecting the appropriate outreach [23] strategies to reach the proper target population was underlined.

Therefore, the objective of this study was to characterize public expectations and needs relating to type 2 diabetes prevention and identify factors associated with willingness to participate in activities aimed at type 2 diabetes prevention among adults in Poland as determinants of the effectiveness of preventive measures.

To the authors’ best knowledge, this is the first study on the expectations and needs relating to type 2 diabetes prevention and on factors associated with willingness to participate in activities aimed at type 2 diabetes prevention among adults in Poland. Most of the respondents declared interest in diabetes-preventing activities was high. Out of Educational level, history of diabetes in the family and presence of chronic diseases were significantly associated with expectations towards participation in activities aimed at preventing type 2 diabetes among those without diabetes, both among all participants as well as those without diabetes.

Those results correspond to the previously published data [27] on the awareness of diabetes in Polish adults. As it was recently confirmed by Sękowski et al. [11], knowledge of diabetes in Poland is strongly related to the patient’s level of education. Rising awareness of diabetes among Polish adults, its risk factors and symptoms results in higher readiness to participate in diabetes prevention actions. However, an educational gradient of this attitude may result in greater health inequalities [28], as only a part of the population is ready to take advantage of such preventive measures. This is especially of consideration in the case of Poland, where a substantial part of the population had never undergone a blood glucose test [29], and the number of undiagnosed patients with type 2 diabetes is estimated to be up to 1 million [30].

Most of the respondents declared willingness to participate in diabetes prevention activities based on healthcare services such as blood sugar tests, consultations with specialists (diabetologists) and family doctors. Lifestyle-related interventions were the least chosen. Those preferences towards medical services and, in consequence, secondary prevention may be due to two reasons.

The Polish health system is considered to have problems in meeting the health needs of the society [31, 32]. Therefore, patients may prefer actions that provide them with the opportunities to meet the demand for health services. This seems especially true for the oldest patients (60+ age group), who most often choose the medical interventions through consultations with a family doctor or a diabetologist (89.5% and 80%, respectively). The inadequate availability of medical services is also perceived as a problem by doctors who provide such services to senior patients [33].

On the other hand, the knowledge of lifestyle-related risk factors for diabetes remains inadequate in Poland [12]. This may result in higher demand for services that meet the social notion of effective diabetes prevention.

Numerous studies have determined the influence of physical activity and exercise on health outcomes. The research indicates that physical activity increases the quality of life and lowers death rates with little to no safety issues [34]. A recent study by Biernat et al. [35] revealed low declared physical activity levels among Poland’s adults. It showed that the likelihood of participation in physical activities depends among other things, on age and education level. Those findings correspond with the results of this study in which sports activities, as a form of diabetes prevention, were chosen mostly by younger participants (70% in the 30–39 age group) with higher education (68.4%) and active occupational status (68.8%). The latter correlates with the findings of Meyer et al. [36], who showed that higher socio-economic status was associated with involvement in all intensity levels of physical activity.

The diet is a second lifestyle factor considered key in diabetes prevention and mitigation of its complications [37]. Some studies show that due to dietary intake, never-married men in Poland manifest, on average, higher systolic and diastolic blood pressure [38] – as risk factors for diabetes [39] and common comorbidities [40]. Despite those circumstances, single respondents were less willing to participate in all diet-related activities (culinary workshops, dietary consultations). Moreover, being single was also negatively correlated with lower preferences towards all consultations with healthcare professionals (family doctors, diabetologists, nurses and educators). Contrasted with, on average, lower quality of life and perceived health condition observed among non-married adults in Poland [41], the attitude of single adults towards preventive health services identified in this study poses a serious challenge.

The results of this study also demonstrated that having a family member with diabetes increases the willingness to participate in all but one (consultation with family doctor) activities. We can hypnotically assume that this is because diabetes has a particular characteristic in that it is a chronic disease that typically manifests in older age, and the patient frequently needs family support and involvement in disease management. Therefore, the patient’s family may have a higher-than-average understanding of this disease (its risk factors and its prevention), as reported by Sękowski et al. [12]. These may complement proper diabetic education that should be offered as part of a public health intervention on diabetes but should not be used in its place. This study has practical implications for the implementation of a community pharmacist-physician collaborative working model in Poland. This study revealed that there is a need to strengthen the role of pharmacists in interprofessional care. Pharmacists should be encouraged to perform drug reviews and report drug interactions and polypharmacy. Pharmacist-physician collaborative working should be included in postgraduate training programs. Both groups should improve communication skills and learn how to build proper relationships based on respect and trust. There is also a need to promote the role of the pharmacist in the healthcare system - no longer as a distributor of drugs, but as an advisor and consultant in matters related to pharmacotherapy [18]. Public authorities should remove barriers to pharmacist-physician collaborative working. Pharmacists should gain access to basic electronic health records that are necessary for pharmaceutical care [16, 42]. Moreover, the development of clear guidelines on what information should be recorded in the patients’ records from the point of view of optimizing pharmacotherapy will also contribute to better cooperation between pharmacists and physicians.