Diet and lifestyle in type 2 diabetes: the patient's perspective

Abstract

Patient compliance with diet, lifestyle and medication regimens is an essential part of the management of type 2 diabetes mellitus. Issues and barriers relating to patient compliance were investigated in group discussions with a total of 123 patients with type 2 diabetes in four European countries and the USA. Patients were found to be well motivated to comply with advice on diet and lifestyle, but many felt they had received insufficient information about their disease and prescribed treatments. In addition, patients often felt that the reasons behind the lifestyle and dietary advice had not been adequately explained, and that dietary advice was vague. Consequently, patients' understanding of the reasons for the changes they believed they had to make was often poor, and they found some lifestyle changes difficult to make. Eating at regular times, not missing meals, reducing alcohol intake or favourite foods, and taking tablets at the same time each day without fail were all directives where a degree of non‐compliance was admitted. There was confusion between diet and lifestyle changes aimed at improving metabolic control and risk profile, and those required to offset the risk of hypoglycaemia inherent in some antidiabetic therapies (e.g. long‐acting sulphonylureas), such as eating meals at set times. It is unfortunate that, by imposing additional diet and lifestyle restrictions, such hypoglycaemic therapies compromise patients' lifestyles and divert their energy and commitments from genuinely beneficial behaviour changes. Copyright © 2002 John Wiley & Sons, Ltd.

How do people with diabetes access information?

“…Previous studies have highlighted the lack of information available to people with diabetes about diet, medication and lifestyle 6. This situation may be exacerbated by inadequate health literacy (defined as inability to read, comprehend and act on medical advice), which is associated with worse glycaemic control and higher rates of retinopathy 7.…”

The association between types of eating behaviour and dispositional mindfulness in adults with diabetes. Results from Diabetes MILES. The Netherlands

“…Dietary modifications, such as changing the amount and type of carbohydrates, as well as the more general requirements to maintain a healthy diet are often a major challenge (Ahola et al, 2012;Bradley & Speight, 2002;Frandsen & Kristensen, 2002). A considerable number of people with type 1 or 2 diabetes find it difficult to reduce or exclude foods they previously enjoyed (Frandsen & Kristensen, 2002).…”

“…Dietary modifications, such as changing the amount and type of carbohydrates, as well as the more general requirements to maintain a healthy diet are often a major challenge (Ahola et al, 2012;Bradley & Speight, 2002;Frandsen & Kristensen, 2002). A considerable number of people with type 1 or 2 diabetes find it difficult to reduce or exclude foods they previously enjoyed (Frandsen & Kristensen, 2002). Chechlacz et al (2009) found stronger activation of brain regions known to be involved in motivation and emotional processing in response to visual food stimuli in people with type 2 diabetes as compared to people without diabetes, especially if the foods depicted had a high fat content.…”

Effect of a nutrition education programme on clinical status and dietary behaviours of adults with type 2 diabetes in a resource-limited setting in South Africa: a randomised controlled trial

“…Barriers to selfcare may be particularly apparent for dietary self-care (10) , an area cited as among the most difficult of diabetes selfcare areas (11) . Poor dietary adherence is a recognised problem in people with T2DM (12)(13)(14) . The barriers associated with the problem are also well documented in the literature (12,14,15) , even for individuals in a resource-limited setting in South Africa (14) .…”