‘I’m on the train and I can't stop it': Western Canadians' reactions to prediabetes and the role of self-compassion

Abstract

Prediabetes, a condition characterised by impaired glucose regulation, is on the rise worldwide. This condition puts people at risk for cardiovascular disease, and 50% of people with prediabetes will develop type 2 diabetes (T2D). People with prediabetes can reduce their risk of developing T2D through lifestyle changes such as regular physical activity and healthy eating. However, the experience of health risks can be associated with negative reactions that can undermine people's ability to self-regulate the health behaviours that would reduce such risk. Self-compassion, or treating oneself kindly in the face of challenge, is known to help people manage negative emotions and facilitate self-regulation. Therefore, self-compassion may be helpful for people with prediabetes who have to manage their health behaviours in the context of a health threat. The purpose of this study was to explore how people, from a small Canadian city who learn that they have prediabetes, react emotionally to their prediabetes diagnosis. We also explored participants' receptivity to applying self-compassion in the context of their prediabetes. Twenty-one adults, recently notified by their doctors as having HbA1c scores indicative of prediabetes (M = 57.76, SD = 5.43), engaged in a semi-structured interview between June 2017 and January 2018. Inductive thematic analysis was used to analyse the data and four themes emerged. Participants' reactions to learning that they had prediabetes were characterised by (a) distress and concern, (b) downplay of T2D risks, (c) guilt and shame, and participants were receptive to (d) self-compassion as a beneficial approach to take in relation to their prediabetes. Findings suggest that people experience negative reactions to their prediabetes diagnosis yet are receptive to self-compassion, which could mitigate these reactions. These findings can inform lifestyle behaviour change programmes for individuals living with prediabetes by providing a better understanding of their perspectives of disease diagnosis.

Facilitators and barriers for lifestyle change in people with prediabetes: a meta-synthesis of qualitative studies

“…Exploring the dimensions of achieving and maintaining lifestyle change At trial, first recruit: > 40 years, Caucasians with BMI > 25 and IGT diagnosed based on two OGTTs n = 15 F = 7 M = 8 Age range: 47–74 Semi-structured interviews, content analysis, framework approach Empirical phenomenology approach Not described Setting: A study nested from the European Diabetes Prevention Study (EDIPS); intervention was individual motivational interviewing (three-month interval) aiming to reduce total food energy and fat intake and increasing activity. Exploring experiences of the participants 3–5 years after Area for lifestyle change (intervention): To promote exercise and dietary changes Strachan et al, 2018, Canada [ 48 ] Exploring how people from a small Canadian city diagnosed with prediabetes react emotionally to their diagnosis Between 18 and 65 years old, diagnosed with prediabetes according to the ADA (2016): HbA1c = 5.7%-6.4% ( n = 20) or ADA risk-questionnaire indicating increased risk (> 5 = 1) within the past year n = 21* F = 18 M = 3 Age range: 47–65 years *A subsample of participants from a larger study on diabetes prevention. The subsample participants were selected by random Semi-structured interviews, inductive thematic analysis (Braun and Clarke) Not described Setting: The study was part of a larger project where people with prediabetes participated in a 3‐week community‐based lifestyle intervention in Western Canada, “Small Steps for Big Changes Program (SSB)”.…”

Falling into a deep dark hole: Tongan people’s perceptions of being at risk of developing type 2 diabetes

“…This metaphor suggests a perception that T2D is an abyss—place of irreversible loss. In another study, participants viewed prediabetes as ‘being on a train that they could not stop’ 37 . Strachan and colleagues found that for many, it was inevitable that the progression of T2D will occur, regardless of health support since the risk factors associated with prediabetes were primarily embedded in the participant's everyday lives.…”

Efficacy of a mindful-eating programme to reduce emotional eating in patients suffering from overweight or obesity in primary care settings: a cluster-randomised trial protocol

“…To relate the awareness of the present moment and the way in which compassionate and critical attitudes towards the self can be managed as possible emotion regulation strategies,56 101 the evaluation of the dispositional mindfulness and self-compassion levels will be pursued as mechanistic variables of the programme through application of the widely used Five Facet Mindfulness Questionnaire (FFMQ), the Mindful Eating Scale (MES) and the Self-Compassion Scale (SCS). Mindfulness is a way of self-regulating attention to focus it on the present moment experience with an attitude of curiosity, openness and acceptance of bodily sensations, thoughts and emotions 102.…”