Recent advancements in lifestyle and technology have increased life expectancy, leading to a rise in chronic diseases like diabetes. Managing these requires strengthening Primary Care (PC). By 2045, diabetes cases are expected to exceed 780 million globally. This study analyzes geographic variations and identifies the determinants of avoidable hospitalizations for diabetic patients in the province of Bolzano (2021–2023). Factors like age, chronic diseases, and adherence to guidelines were examined using count regression models. The hurdle negative binomial model with random effects for the health subdistrict was the best specification. In 2021, the prevalence of Type 2 diabetes was 4%. Of 16,707 diabetic patients, 17.5% had at least one avoidable hospitalization. Older age, more chronic diseases, lower compliance with diabetes guidelines, and proximity to hospitals increased hospitalization risk. This study serves as a valuable starting point for further analysis to support health policy decisions and measures to move toward high-value healthcare.