Background: Diabetes mellitus represents a major global public health challenge and is associated with a substantial burden of chronic microvascular and macrovascular complications. Regular screening for diabetes-related complications is essential for early detection, timely intervention, and prevention of irreversible damage. Contemporary diabetes screening protocols extend beyond laboratory and clinical assessments to include radiological and imaging-based investigations, such as retinal imaging for diabetic retinopathy, Doppler ultrasound for peripheral arterial disease, and renal ultrasound for diabetic nephropathy, as recommended by international guidelines (World Health Organization, 2023; American Diabetes Association, 2024). Despite their proven clinical value, adherence to recommended screening schedules—including radiological screening—remains suboptimal. Increasing evidence indicates that psychological and social determinants significantly influence patients’ engagement with preventive and diagnostic imaging services. Within primary healthcare systems, general practitioners (GPs) are uniquely positioned to address these determinants through holistic, patient-centered care.

Objective: This narrative review aims to examine the contribution of general practitioners to enhancing adherence to regular diabetes screening, with particular emphasis on radiological and imaging-based screening, through psychological and social support, focusing on evidence relevant to the Saudi Arabian healthcare context.

Methods: A narrative review of the literature was conducted using international clinical guidelines, systematic reviews, and empirical studies addressing diabetes screening adherence, psychosocial determinants of health, and GP-led interventions in primary care. Particular attention was given to studies examining adherence to radiological screening modalities for diabetes complications. Both global and Saudi-based peer-reviewed studies were included to ensure contextual relevance and applicability to the Saudi healthcare system.

Results: The reviewed evidence indicates that psychological factors—such as diabetes-related distress, depression, anxiety, fear of abnormal imaging findings, and maladaptive health beliefs—constitute major barriers to adherence to regular screening, including radiological investigations. Social determinants, including family support, health literacy, socioeconomic constraints, cultural beliefs, and healthcare system factors, further influence patients’ acceptance of and engagement with imaging-based screening. General practitioners play a pivotal role in mitigating these barriers by providing psychosocial support, offering reassurance regarding radiological procedures, fostering patient trust, addressing emotional concerns, engaging family members, and coordinating referrals for diagnostic imaging. In Saudi Arabia, the high prevalence of diabetes, cultural influences on healthcare-seeking behavior, and the central role of primary care underscore the importance of GP-led, psychosocially informed approaches to improving adherence to radiological screening. Nevertheless, challenges related to time constraints, training in psychosocial care, and integration between primary care and radiology services persist.

Conclusion: Adherence to regular diabetes screening, including radiological and imaging-based assessments, is strongly influenced by psychological and social factors that extend beyond biomedical care alone. General practitioners are central to addressing these determinants within primary care settings. Strengthening GP capacity to deliver psychosocial support, alongside improved integration of radiological services and mental health and social care within primary healthcare systems, may substantially enhance screening adherence and reduce the burden of diabetes complications—particularly in high-prevalence settings such as Saudi Arabia.