scholarly journals Insights of healthcare providers and patients on implementation of dietary/lifestyle intervention for reversal of obesity and type 2 diabetes: a qualitative study

2021 ◽  
Vol 8 (7) ◽  
pp. 3533
Author(s):  
Tanica Lyngdoh ◽  
Neha Sharma ◽  
Sanjay Zodpey
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Modification ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Self Management ◽  
Eating Frequency ◽  
Active Involvement ◽  
Adherence To Diet ◽  
Management Regime

Background: A diet plan that includes limiting eating frequency to twice a day along with other lifestyle modification was implemented as part of a campaign for diabetes reversal. The objective of this study was to identify facilitators and barriers to practice of this self-management regime among adults with type 2 diabetes mellitus (T2DM) living in urban communities.Methods: Participants included purposively sampled 10 diabetics recruited from 12 Diabetes Reversal Centres (DRCs) located across Maharashtra, Goa, Karnataka and Gujarat in India. Additionally, healthcare providers (including 10 doctors and 10 coordinators) from these centres were interviewed. Data collection employed in-depth interviews using structured interview guides. Thematic data analysis was undertaken to identify themes.Results: Continued rapport and supervisory role of the healthcare providers in the DRCs was the key facilitator in helping patients to assume responsibility and adhere to the diet regime for self-management. Visible reduction in sugar levels and body weight were other rewarding benefits that motivated sustained compliance. Social and cultural aspects (including social functions and formalities) was a perceived barrier that interfered with adherence to diet regime and goals. A common suggestion from both the healthcare providers and patients was the need to expand this initiative through capitalizing on use of relevant technological devices.Conclusions: In conclusion, a self-management patient model where there is continued and active involvement of healthcare providers through all stages is a recipe for success. However, this initiative can be further strengthened through complementing it with individualized, context-driven solutions to address the barriers. 

scholarly journals Significant Reduction in Hba1c and BMI After Three Months of Personalized Glycemic Response Based Coaching for Patients With Type 2 Diabetes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A476-A476
Author(s):  
Tejal Lathia ◽  
Snehal Tanna ◽  
Mahesh Padsalge ◽  
Archana Juneja ◽  
Piya Ballani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Modification ◽  
Patient Adherence ◽  
Glucose Monitoring ◽  
Lifestyle Changes ◽  
Glycemic Response ◽  
Self Monitoring ◽  
Adherence To Diet ◽  
Improve Patient Adherence

Abstract Background/Objective: Patients with type 2 diabetes face challenges when it comes to following recommendations (nutrition, exercise and medications). Using technology to understand glycemic responses can increase patient awareness about dietary and lifestyle changes. Coupled with coaching by an expert nutritionist, such a program may help improve patient adherence, resulting in a reduction in HbA1c and body mass index (BMI). Method: Fifty-seven patients with type 2 DM not at goal (HbA1c ≥ 6.5%) either on lifestyle modification, OHA with or without insulin, consenting to participate in the study were enrolled in the DIABEFLY program which included Ambulatory glucose monitoring (AGM) and correlating it with dietary intake for 14 days using a technology platform (FITTERFLY wellness app). Patients were explained their AGM graphs, in relation to their daily food and activity log, to make them aware of their personalised glycemic responses to various foods and accordingly diet plan was suggested. Nutritionists (coaches) interacted with patients over calls on Day 1, 7, 14, 30, 60 and Day 90 to explain recommendations, address any diabetes related queries and evaluate adherence to diet & exercise plans. Patients also had access to daily chat support for 90 days and received daily messages on glycemic responses, healthy food choices, exercise options, stress management, sleep, medication adherence, self-monitoring of blood glucose and complications of diabetes. Strictly, no advice on type or dosage of medication was given by the coaches. Statistical analysis for outcomes was done by t-test using SPSS software. Result: Out of 57 patients, mean age was 46 years, of which 70% were male and 30% were females. The baseline HbA1c was found to be 8.3% ± 1.68 which significantly decreased (p<0.05) to 7.4% ± 1.36 in 3 months. The Baseline BMI of 27.1± 4.9 kg/ sq m was significantly reduced (p<0.05) to 26.6±4.6 kg/sq m in 3 months. Discussion: With the availability of AGM devices, powerful food databases and technology to correlate these two had led to a new era of diabetes coaching. The personalised glycemic responses so calculated for every patient lead to more concrete understanding of changes necessary for better glycemic control. Regular interactions or reminders from an expert may act as a unique and necessary way of reinforcement to follow recommendations. In our study, though increased engagement with the programme resulted in a significant reduction in HbA1c and BMI. Conclusion: Personalized Glycemic response led coaching benefits patients with Type 2 diabetes mellitus helping them achieve two critical outcomes - lowering of HbA1c and reduction of BMI as early as three months. Keywords: AGM; Personalised glycemic response; Diabetes lifestyle coaching

scholarly journals Barriers to Effective Diabetes Mellitus Self-Management (DMSM) Practice for Glycemic Uncontrolled Type 2 Diabetes Mellitus (T2DM): A Socio Cultural Context of Indonesian Communities in West Sulawesi

2019 ◽  
Vol 10 (1) ◽  
pp. 250-261 ◽  
Author(s):  
Rian Adi Pamungkas ◽  
Kanittha Chamroonsawasdi ◽  
Paranee Vatanasomboon ◽  
Phitaya Charupoonphol
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Social Engagement ◽  
Cultural Context ◽  
Healthcare Providers ◽  
Self Management ◽  
Glucose Levels ◽  
Village Health Volunteers

Diabetes mellitus self-management (DMSM) is an essential strategy used to maintain blood glucose levels and to prevent severe complications. Several barriers have been documented while implementing DMSM practices. A qualitative study aimed to explore barriers to effective DMSM practice among uncontrolled glycemic type 2 diabetes mellitus (T2DM) patients in Indonesia. We conducted in-depth interviews and focus group discussions (FGDs) among 28 key informants, including patients, family members, healthcare providers (HCPs), and village health volunteers (VHVs). The interviews and FGDs were audiotaped and transcribed verbatim. The results revealed six core themes with sub-categories of themes used by all participants to describe the barriers to effective DMSM practice among uncontrolled T2DM patients. The critical barriers of DMSM practice included low perception of susceptibility to and severity of the illness; inadequate knowledge and skill of diabetes mellitus self-management; lack of motivation to perform diabetes mellitus self-management; insufficient human resources; lack of social engagement; and social exclusion and feelings of embarrassment. Our findings provide valuable information regarding the barriers while implementing the DMSM practice. Healthcare providers should negotiate with both T2DM patients and caretakers to participate in a DMSM program at a community health care level.

On-Demand, App-Delivered Coaching to Enable Diabetes Self-Management in Adults with Type 2 Diabetes—A Feasibility Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 50-LB
Author(s):  
JOHN B. HERNANDEZ ◽  
AMY ARMENTO LEE ◽  
SCOTT ROBERTSON ◽  
CARA SILVER ◽  
AMIT MAJITHIA
Keyword(s):  
Type 2 Diabetes ◽  
Feasibility Study ◽  
Self Management ◽  
On Demand

2180-PUB: Integration of Continuous Glucose Monitoring in Diabetes Self-Management Education for Type 2 Diabetes Improves Glycemic Control

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2180-PUB
Author(s):  
ADDIE L. FORTMANN ◽  
ALESSANDRA BASTIAN ◽  
CODY J. LENSING ◽  
SHANE HOVERSTEN ◽  
KIMBERLY LUU ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Management Education ◽  
Glucose Monitoring ◽  
Self Management

scholarly journals Mediating role diet self-efficacy plays in the relationship between social support and diet self-management for patients with type 2 diabetes

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Li Yang ◽  
Kun Li ◽  
Yan Liang ◽  
Qiuli Zhao ◽  
Dan Cui ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Self Efficacy ◽  
Self Management ◽  
Mediating Role ◽  
Diet Behavior ◽  
The Relationship

Abstract Background It has previously been established that patients who have strong barriers to their diet self-management are more likely to have weak social support; however, the key mechanisms underlying the association between these two variables have not yet been established. This study aims to examine the potential role that diet self-efficacy plays in the relationship between social support and diet behavior in patients with type 2 diabetes mellitus (T2DM). Methods It was a cross-sectional survey. Three hundred-eighty patients diagnosed with T2DM were recruited for this study from five community health centers in China. The Chronic Disease Resource Scale (CIRS), Cardiac Diet Self-efficacy Scale (CDSE), and Food Control Behavior Scale (FCBS) were used to estimate participants’ utilization of social resources, diet self-efficacy, and diet self-management, respectively. The data were analyzed utilizing structural equation modelling. Results The results suggest that both higher levels of social support and diet self-efficacy are related to higher levels of diet self-management. The mediating effect that diet self-efficacy has on the relationship between social support and diet self-management was significant (β = .30, p < .05), explaining 55.68% of the total effect of social support on diet self-management. Conclusions Diet self-efficacy plays a mediating role in the association between social support and diet behavior in patients with type 2 diabetes mellitus.

Type 2 diabetes self-management schemas across diverse health literacy levels: a qualitative investigation

2021 ◽  
pp. 1-21
Author(s):  
Julie Ayre ◽  
Carissa Bonner ◽  
Danielle M. Muscat ◽  
Sian Bramwell ◽  
Sharon McClelland ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Literacy ◽  
Self Management ◽  
Qualitative Investigation

scholarly journals Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stijn Crutzen ◽  
Tessa van den Born-Bondt ◽  
Petra Denig ◽  
Katja Taxis
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Food Intake ◽  
Mixed Methods Study ◽  
Self Management ◽  
Hypoglycaemic Event ◽  
Glucose Levels ◽  
Management Issues

Abstract Background Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients. Methods In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past. Results Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%. Conclusion People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.

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