Tanzania has an estimated 2.9 million adults with diabetes, 35% of whom are undiagnosed, and over 22,000 people living with type 1 diabetes. While the 2023 Universal Health Insurance law aims to improve access to care, only 15% of people are insured. Over 700 clinics provide diabetes care and offer free insulin to children and young adults. However, challenges remain regarding insulin availability, diagnostics, patient education and the healthcare workforce. Community engagement, training and policy advocacy are essential for improving diabetes management and achieving universal health coverage.