Type 2 diabetes is at least 4 times more common among British South Asians than in the general population. South Asians also have a higher risk of diabetic complications, a situation which has been linked to low levels of physical activity observed amongst this group. Little is known about the factors and considerations which prohibit and/or facilitate physical activity amongst South Asians. This qualitative study explored Pakistani (n = 23) and Indian (n = 9) patients' perceptions and experiences of undertaking physical activity as part of their diabetes care. Although respondents reported an awareness of the need to undertake physical activity, few had put this lifestyle advice into practice. For many, practical considerations, such as lack of time, were interwoven with cultural norms and social expectations. Whilst respondents reported health problems which could make physical activity difficult, these were reinforced by their perceptions and understandings of their diabetes, and its impact upon their future health. Education may play a role in physical activity promotion; however, health promoters may need to work with, rather than against, cultural norms and individual perceptions. We recommend a realistic and culturally sensitive approach, which identifies and capitalizes on the kinds of activities patients already do in their everyday lives.

Objective To explore British Pakistani and British Indian patients' perceptions and experiences of taking oral hypoglycaemic agents (OHAs). Design Observational cross sectional study using in-depth interviews in English or Punjabi. Setting and participants 32 patients of Pakistani and Indian origin with type 2 diabetes, recruited from primary care and community sources in Edinburgh, Scotland.

Perceptions that South Asian foodstuffs necessarily comprise 'risky' options need to be tackled amongst patients and possibly their healthcare providers. To enable Indians and Pakistanis to manage their diabetes and identity simultaneously, guidelines should promote changes which work with their current food practices and preferences; specifically through lower fat recipes for commonly consumed dishes. Information and advice should be targeted at those responsible for food preparation, not just the person with diabetes. Community initiatives, emphasising the importance of healthy eating, are also needed.

Gratitude for free services in Britain may instil a sense of indebtedness which makes it difficult for Pakistanis and Indians to be critical of their diabetes care. Health-care professionals may need to describe their roles carefully, and explain how different diabetes services fit together, to avoid Pakistani and Indian patients perceiving treatment as unsatisfactory. Whilst linkworker schemes may meet patients' need to receive culturally sensitive information in their first language, work is needed to assess their effectiveness and sustainability.