Diabetes affects everything: Type 2 diabetes self‐management among Spanish‐speaking hispanic immigrants

Abstract

This article is a report of qualitative findings of a mixed-methods study of the relationships among knowledge, self-efficacy, health promoting behaviors, and type 2 diabetes mellitus (T2DM) self-management among limited-english-proficient recent Hispanic immigrants, a population with increased incidence of T2DM and barriers to successful T2DM management. Semi-structured interviews were conducted with 30 participants, and physiological and demographic data also were collected. The participants generally attributed developing the disease to strong emotions and viewed T2DM as a serious disease. Although a majority understood the importance of exercise and diet in T2DM self-management, other aspects such as medication adherence were not well-understood. Obstacles to effective T2DM self-management were negative interactions and communications with health care providers and other personnel, cultural stigma related to the disease, financial constraints, immigration status, and the complexity of the disease. Suggested interventions to improve the care and self-management of this at-risk population are discussed.

Making sense of blood glucose data and self‐management in individuals with type 2 diabetes mellitus: A qualitative study

“…Participants evaluated the adequacy of glycaemic control represented by each hypothetical glucose data set by analysing individual values and trends and comparing them with their own parameters and experiences. Other studies have noted that individuals use their blood glucose data as feedback for how well they are managing their diabetes (Ancker et al., 2015;Smith‐Miller et al., 2017). Frequent glucose assessments have been associated with significant decreases in HbA1C levels (Elgart et al., 2016;Ziegler et al., 2011).…”

“…Other researchers have found that social gatherings represented a challenge to individuals. Food was often a central feature at such events, and they found it difficult to be around others who consumed food not recommended for people with diabetes mellitus (Smith‐Miller et al., 2017;Wilkinson et al., 2014).…”

“…Adherence to an effective diabetes self‐management regimen is a challenge for many (Ancker et al., 2015;Smith‐Miller, Berry, & Miller, 2017). Healthy eating habits are a cornerstone of effective diabetes self‐management but can be difficult to maintain (American Association of Diabetes Educators, 2014).…”

“…Healthy eating habits are a cornerstone of effective diabetes self‐management but can be difficult to maintain (American Association of Diabetes Educators, 2014). For example, individuals have difficulty adhering to their diet at social gatherings because food and drink are often an integral part of such events (Smith‐Miller et al., 2017;Wilkinson, Whitehead, & Ritchie, 2014). Engaging in recommended physical activity is a challenge for some individuals with barriers including time and functional constraints (Adeniyi, Anjana, & Weber, 2016;Smith‐Miller et al., 2017).…”

“…For those who take less frequent insulin injections or are on noninsulin therapies, self‐monitoring of blood glucose as part of an educational programme may help guide treatment decisions and/or self‐management (American Diabetes Association, 2018b). Researchers have noted that individuals report using blood glucose monitoring to determine when to contact healthcare personnel, adjust diet and medication, and/or as feedback about their self‐management efforts (Ancker et al., 2015;Huniche, Dinesen, Nielsen, Grann, & Toft, 2013;Smith‐Miller et al., 2017). Reasons for not monitoring their glucose include perceptions of good health and not viewing monitoring as relevant (Huniche et al., 2013).…”