Participant observation was conducted to explore the understanding of diabetes and examine the implications of these understandings for providing effective patient centered care in Cameroon. Ethnographic techniques—content and thematic analysis—were used to analyze the data collected from diverse techniques. Most participants distinguished “natural,” “supernatural,” and “man-made” causes of diabetes. Such aetiologies guided the behaviour and approaches adopted for treatment and helped explain why biomedical and traditional healing frameworks could so readily be used in tandem. Clinical encounters are often only one small part of the diabetes care process, alongside recourse to traditional medicine. With rituals, agents causing diabetes are apparently more convincingly explained as powerful reinforcement and a cure promised in traditional medicine. Though it seems “irrational” and dangerous to clinics when patients alternate between therapeutic regimes or pursue both simultaneously, it seems perfectly rational and beneficial to patients and beyond. So long as biomedical practitioners fail to recognize that their patients will probably also have recourse to traditional medicine, they and their services may compound the problems they face for patients to discuss openly how they have been managing their condition.