An Exploration of the Patient Lived Experience of Remission and Relapse of Type 2 Diabetes Following Bariatric Surgery

Abstract Background Bariatric surgery is the most effective treatment for patients with obesity and type 2 diabetes (T2DM), inducing profound metabolic changes associated with improvements in glycaemic control. In spite of the recognition of the physiological changes associated with bariatric surgery, what remains underappreciated is the patient experience of surgery to treat T2DM. Objectives This study explored the patient experience with regard to motivations, expectations and outcomes, including remission and relapse of diabetes. Methods An in-depth qualitative approach was adopted, encompassing semi-structured interviews with patients (n=17) living with obesity and T2DM both pre- and postsurgery. Interpretive thematic analysis identified emergent themes using a grounded approach. Results Analysis revealed a number of themes throughout the interviews which included motivations and perceived benefits of surgery, obesity stigma and its impact on self-worth as well as perceptions of remission or relapse and the implications for sense of control. Conclusions The motivation for undergoing bariatric surgery was driven by health concerns, namely T2DM and the desire to reduce the risk of developing diabetes-related complications. Patients highlighted social and self-stigmatisation associated with obesity and T2DM, leading to feelings of shame and an inability to seek support from family or healthcare professionals. Stigmatisation created a sense of failure and feeling of guilt for having T2DM. As a result, patients felt responsible for maintaining disease remission postoperatively and regarded the need for medication as a sign of treatment failure.

Download Full-text

Five‐year effectiveness of bariatric surgery on disease remission, weight loss, and changes of metabolic parameters in obese patients with type 2 diabetes: A population‐based propensity score‐matched cohort study

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.3236 ◽

2020 ◽

Vol 36 (3) ◽

Cited By ~ 2

Author(s):

Tingting Wu ◽

Simon Kin Hung Wong ◽

Betty Tsz Ting Law ◽

Eleanor Grieve ◽

Olivia Wu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Weight Loss ◽

Cohort Study ◽

Propensity Score ◽

Population Based ◽

Obese Patients ◽

Matched Cohort ◽

Disease Remission

Download Full-text

Attitudes and opinions of Oral healthcare professionals on screening for Type-2 diabetes

BMC Health Services Research ◽

10.1186/s12913-021-06756-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rodrigo Mariño ◽

Andre Priede ◽

Michelle King ◽

Geoffrey G. Adams ◽

Diego Lopez

Keyword(s):

Type 2 Diabetes ◽

Oral Health ◽

Healthcare Professionals ◽

Healthcare Setting ◽

Successful Implementation ◽

Medical Screening ◽

Structured Interviews ◽

Healthcare Settings ◽

Collaboration And Communication

Abstract Background As part of a larger study on the identification of undiagnosed Type 2 diabetes (T2D), and prediabetes patients in dental settings, this study explored oral healthcare professionals’ (OHP) attitudes with respect to the relevance and appropriateness of screening for prediabetes/T2D in general oral healthcare settings. It also aims to gain a deeper understanding of OHPs’ concerns and perceived barriers to screening for T2D. Methods Semi-structured interviews were conducted with 11 OHPs: eight dentists, two dental hygienists and one oral health therapist. Interviews were audio recorded, transcribed verbatim and analysed using thematic analysis. Results Themes that emerged from the interviews were organised under three major categories: 1) Implementation: OHPs willingness to screen for prediabetes/T2D; 2) Barriers to implementation of screenings; subdivided into: a) lack of knowledge and formal training about T2D screening methodology; b) concerns about patients’ awareness and acceptance of T2D screening in oral healthcare settings; c) costs and reimbursement for the time and resources required to screen patients; and d) legal and scope of practice; and 3) Collaboration and communication between OHPs and General practitioners (GP). Conclusions The oral healthcare setting was considered as appropriate for medical screening, and OHPs were willing to participate in screening for prediabetes/T2D. Nonetheless, for the successful implementation of a screening programme, several barriers need to be addressed, and effective medical screening would require collaboration between oral health and medical and other health professionals, as well as clarification of legal and reimbursement issues.

Download Full-text

Decolonizing Diabetes

International Journal of Indigenous Health ◽

10.32799/ijih.v14i2.31895 ◽

2019 ◽

Vol 14 (2) ◽

pp. 252-275

Author(s):

Roger Stephen Pilon ◽

Monique Benoit ◽

Marion Maar ◽

Sheila Cote ◽

Fern Assinewe ◽

...

Keyword(s):

Type 2 Diabetes ◽

Lived Experience ◽

Indigenous Peoples ◽

Research Question ◽

Structured Interviews ◽

Northern Ontario ◽

Main Research ◽

The Impact ◽

The Way

This article presents insights into the colonial experience of Indigenous Peoples living with type 2 diabetes within seven First Nation communities in Northern Ontario. A constructivist grounded theory methodology, guided by a decolonizing and participatory action approach to conducting research with Indigenous Peoples, was utilised in this study. Twenty-two individuals with type 2 diabetes were interviewed. The main research question explored the impact of colonization on the lived experience and perceptions about developing type 2 diabetes for Indigenous Peoples. Using semi-structured interviews, the three main categories that emerged from the analysis of the interview transcripts were changing ways of eating, developing diabetes, and choosing your medicine. A substantive theory was developed that suggests that Indigenous Peoples, with type 2 diabetes, often live with the perception that there is ‘no going back’ to the way things once were prior to European contact. As a result, they have adapted the way they live with diabetes which can, at times, be at odds with Indigenous world views. An adaptation that considers a complementary approach to the way individuals live and manage diabetes including both Traditional and Western ways may provide a framework for a decolonized model of type 2 diabetes care for Indigenous Peoples.

Download Full-text

Understanding the experiences of long-term maintenance of self-worth in persons with type 2 diabetes in Japan: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2019-034758 ◽

2020 ◽

Vol 10 (8) ◽

pp. e034758

Author(s):

Asuka Kato ◽

Kazuhiro Yoshiuchi ◽

Yuko Fujimaki ◽

Shin Fujimori ◽

Yuka Kobayashi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Qualitative Study ◽

Healthcare Professionals ◽

Sense Of Self ◽

Self Management ◽

Diabetes Treatment ◽

Cross Sectional ◽

Self Worth

ObjectivePersons with type 2 diabetes are often stigmatised for having what is considered a lifestyle-related disease. Accordingly, some blame themselves for their condition, resulting in feelings of low self-worth that ultimately impact their self-management behaviours. However, there are no studies examining why some do not blame themselves for their condition and manage to maintain their self-worth in relation to their illness. This study aimed to explore an understanding of how such persons experience the maintenance of self-worth in relation to their illness over the lifelong course of treatment.DesignA cross-sectional qualitative study. Face-to-face semistructured interviews were conducted with a purposive sampling strategy. The data was analysed using a qualitative descriptive method that involved concurrent data collection and constant comparative analysis.SettingTwo tertiary-level hospitals in Japan.ParticipantsThirty-three outpatients with type 2 diabetes who currently had good glycaemic control but had previously had poor glycaemic control.ResultsThree themes explaining the maintenance of self-worth were identified: (1) Participants gained ‘control’ over their illness by living a ‘normal life.’ They found a way to eat preferred foods, dine out with family and friends, travel and work as usual; (2) Participants discovered the positive aspects of type 2 diabetes, as they felt ‘healthier’ from the treatment and felt a sense of security and gratitude for the care they received from healthcare professionals; (3) Participants discovered a new sense of self-worth by moving towards goals for type 2 diabetes treatment and experienced inner growth through positive lifestyle choices.ConclusionsThe process of restoring and maintaining self-worth should be brought to the attention of healthcare professionals in diabetes care. These professionals could help patients discover positive self-representations through diabetes treatment (eg, a realisation that one does not lack self-control) and could aid in increasing patient engagement in diabetes self-management.

Download Full-text