Experiences of food abstinence in patients with type 2 diabetes: a qualitative study

Abstract

ObjectivePeople with type 2 diabetes often report pressure to abstain from many of life's pleasures. We tried to reconstruct these patients’ sense of pressure to better understand how people with diabetes make sense of, and integrate, these feelings into their life.Design, setting and participantsA secondary analysis of narrative interviews with 14 patients with type 2 diabetes who are part of a website project.Main outcome measuresGrounded theory-based analysis of narrative interviews, consisting of open, axial and selective coding.ResultsPeople with type 2 diabetes felt obliged to give up many pleasures and live a life of abstinence. They perceived a pressure to display a modest culinary lifestyle via improved laboratory test results and weight. Their verbal efforts to reassure and distance themselves from excessiveness indicate a high moral pressure. With regard to the question of how to abstain, food and behaviour were classified into healthy and unhealthy. Personal rules sometimes led to surprising experiences of freedom.ConclusionsPeople with diabetes have internalised that their behaviour is a barrier to successful treatment. They experience an intensive pressure to show abstinence and feel misjudged when their efforts have no visible effect. Taking into account this moral pressure, and listening to patients’ personal efforts and strategies to establish healthy behaviours, might help to build a trusting relationship with healthcare providers.

Exploring the barriers and facilitators of dietary self-care for type 2 diabetes: a qualitative study in Ghana

“…34,45 This finding also supports another qualitative study in Germany, which found that people with T2D often experience an intense moral pressure to give up many pleasures and live a life of abstinence from certain foods in order to better control the disease - and suggest that taking into account this moral pressure, and patients’ personal efforts and strategies to establish healthy behaviours, might help to build better and trusting patient-provider relationships. 46…”

RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020

“… Fasting or healthy abstinence from food, is a form of lifestyle modification for T2DM patients and if utilized appropriately, may result in several health benefits to these patients. [ 895 ] Pre-fasting diet should include slow release foods and patients with T2DM should not indulge in over-eating in the post-fasting period in order to avoid postprandial hyperglycaemia. [ 895 ] Therefore, complex carbohydrates like whole grains, potato, berries, citrus fruits, apple, nuts and legumes at pre-fasting, and simple carbohydrates like bread, cereals, rice, and pasta at post-fasting may be more appropriate to reduce complications.…”

“…[ 895 ] Pre-fasting diet should include slow release foods and patients with T2DM should not indulge in over-eating in the post-fasting period in order to avoid postprandial hyperglycaemia. [ 895 ] Therefore, complex carbohydrates like whole grains, potato, berries, citrus fruits, apple, nuts and legumes at pre-fasting, and simple carbohydrates like bread, cereals, rice, and pasta at post-fasting may be more appropriate to reduce complications. [ 886 ] During prolonged fasting periods like Ramadan or Navaratri, physical activity should be restricted.…”

“…Fasting or healthy abstinence from food, is a form of lifestyle modification for T2DM patients and if utilized appropriately, may result in several health benefits to these patients. [ 895 ]…”

Significados e práticas dietéticas entre idosos diagnosticados com diabetes mellitus tipo 2

“…Considerando a relevância da alimentação e o impacto causado no cotidiano das pessoas com diabetes mellitus tipo 2, a dieta foi analisada com ênfase nas dificuldades para a mudança, na pressão moral a que são submetidos os que estão em tratamento (4) e na subjetividade encontrada nos modelos explicativos (5) . Pessoas que convivem com diabetes DM2 percebem que o comportamento alimentar é uma barreira que deve ser superada para obter melhor condição de saúde e sucesso no tratamento (5) .…”