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This paper examines the application of syndemic theory to co morbidities and multi morbidities in low-income and middle-income countries. The study takes diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, the study illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients.