Abstract: Diabetes, an escalating non-communicable disease (NCD) in Sub-Saharan Africa (SSA), poses significant management challenges, particularly in rural areas like Makueni Sub-County, Kenya, where limited resources and socio-economic barriers intensify its impact. The study used a mixed-methods and parallel convergent study design. Quantitative data were collected using the Morisky Medication Adherence Scale (MMAS-8), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Multidimensional Scale of Perceived Social Support (MSPSS), and pharmacy records, were analyzed in SPSS v.28 using descriptive and inferential statistics. Qualitative data from 20 semi-structured interviews were thematically analyzed. Findings revealed that, Knowledge level on prescribed medication was moderate (55% correct), lower in rural areas (48% vs. 71.9%, χ² = 10.34, p = .001), and among less educated individuals (45.3% vs. 73.3%, χ² = 14.62, p < .001), with misconceptions such as “insulin is optional.” The study concluded that systemic rural barriers in Makueni drive poor adherence and well-being, necessitating subsidized medications, reliable supply chains, and expanded CHW programs to enhance diabetes outcomes. The study recommends that culturally sensitive education programs and community-based diabetes support groups should be developed to address misconceptions, leverage existing family and faith-based support, and reduce stigma, thereby enhancing knowledge and quality of life. 

Keywords: Level of Knowledge, Adherence, Prescribed Medication, Regimens, Diabetic Patients