Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

Abstract

Objective. To explore how food insecurity affects individuals’ ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants’ experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

Coping strategies and their association with diabetes specific distress, depression and diabetes self-care among people living with diabetes in Zambia

“…Diabetes self-care can be very complex, challenging and stressful [ 1 , 2 ], especially in developing countries where health care and formal support systems are still underdeveloped [ 3 ]. Daily self-management involves frequent blood glucose monitoring and insulin adjustments and administration, engaging in physical activities, consideration of nutrition, managing sleep duration and blood glucose level.…”

Self-care practices and its determinants among diabetic population in rural Andhra Pradesh, India: A cross-sectional study

“…These challenges can be at various levels, including the health system-level or individual-level, and the types of challenges vary in different parts of the world. [22][23][24][25] At the individual level, besides compliance with the medicines, a sustained self-care practice is required to achieve the therapeutic goals. 25 In India, individual self-care is often at stake due to a lack of fragmented information systems and inadequate patient support.…”

Barriers related to self-care management among people with diabetes mellitus- A narrative review

“…Lack of support system related to family, peer group, friends, society, finance, professional assistance and medical guidance leads to negative impact on self-care behaviour. Although an important element, most the research evidences reported existence of poor support system (13,16,20). Not getting desired support from family members, lack of agreement on decisions making and conflict with the family members put a significant challenge (17).…”

“…Diabetes is a chronic ailment which needs lifelong adherence to many lifestyle modifications and treatment modalities. Degree and severity of symptoms have been found to be related with the practice of self-care care activities among diabetic persons (16,24). Moreover the presence of other comorbidities such as HTN, Hyperlipidaemia and obesity also impact significantly the self-management process.…”

“…The lived experience of people living with diabetes reported many strains related to dehydration and binge eating during fasting (18). Moreover, cultural constraints and difficulty in dietary restriction has been identified as a major obstacle (15,16).…”