A Comparison of Views of Individuals with Type 2 Diabetes Mellitus and Diabetes Educators About Barriers to Diet and Exercise

Abstract

Diet and exercise are the cornerstones of treatment for persons with type 2 diabetes mellitus, yet patients find these areas of self-management to be the most difficult. Considerable research has indicated that barriers to diet and exercise are critical influences determining adherence to diet and exercise plans. Standards of practice require educators to assess patient barriers to self-management. However, little research has investigated whether patients and educators perceive these barriers similarly. This project's objectives were to compare and contrast patients' and educators' perspectives of patient barriers to following a meal or exercise plan, and to identify differences in patients' perceived barriers as related to patient characteristics. Patients with type 2 diabetes mellitus (n = 97) from three eastern Washington area hospitals and diabetes educators (n = 143) from the Washington Association of Diabetes Educators (WADE) were recruited for a mail survey. From the patient survey, the proportion of patients on meal plan (52%) or exercise plan (26%) was low. Certain barriers were prominent for both patients and educators relative to diet (difficulty maintaining a diet away from home, liking foods not in the meal plan) and exercise (not a high priority, weather). However, multivariate analyses indicated that patients and educators view barriers differently. Similarities and differences between educators and patients in response to barriers are discussed relative to enhancing diabetes counseling and education, and overall communication between educators and patients.

Needs and preferences for nutrition education of type 2 diabetic adults in a resource-limited setting in South Africa

“…Health professionals particularly emphasised the problem of food portion control. This was also observed in the study by Shultz et al (2001) involving diabetes educators and type 2 diabetic patients. The findings thus indicate a gap between dietary recommendations awareness and practice which could be attributed to the barriers identified in this study population.…”

“…Although diet is an essential component of diabetes care, dietary adherence is reported by both health professionals and patients to be the most difficult amongst diabetes self-care areas (Sullivan & Joseph 1998;Vijan et al 2005, Nagelkerk, Reick & Meengs 2006Shultz et al 2001;Rosal et al 2004). This problem is particularly apparent in low-income groups (Cox et al 2004).…”

Adherence of Diabetic Patients to the Recommendations on Diabetes in Kayseri

“…7,23,24 The physical activity adherence rate in some studies varied between 37 and 52%. 20,25 The rates of regular visits to a physician, physical exercise and foot care were low in the study group (Table 3).…”

“…[16][17][18] In the present study, 59.5% of the patients reported adherence to an appropriate diet, whereas other studies stated adherence to an appropriate diet as 37-52%. 19,20 Effective self-management is considered the cornerstone of successful diabetes control, and monitoring of blood glucose may have a role in this situation. Self monitoring of blood glucose is correlated with better control of diabetes.…”

Dietary and physical activity counselling on Type 2 diabetes and impaired glucose tolerance by physicians and nurses in primary healthcare in Finland

“…In this study, as in earlier studies [10,12], the physicians and nurses often devoted little time to dietary and physical activity counselling. In Finland, diabetes counselling for outpatients is organized in primary healthcare units and nurses and physicians play a major role in health counselling [22].…”