Voices of diabetes: hearing the lived experience

Diabetes is a health issue of rising prevelance across the world, alongside an obesity epidemic and aging population. It is a complex condition which requires proactive self-management in order to achieve glycaemic control1 and reduce risk of lifechanging complications. This thesis addresses two types of diabetes, Type-2 Diabetes Mellitus (T2DM) and Gestational Diabetes Mellitus (GDM). Although the cause and development are different, both these forms of diabetes often require significant lifestyle and behavioural change. It is therefore important to understand the experiences of patients to ensure they are adequately supported. This thesis aimed to inform understanding of their experiences. Chapter one presents a systematic review of the qualitative literature to understand the experiences of pregnant women self-managing GDM in the context of western maternity care services. Sixteen articles were included and critiqued in the review. Women described the sudden unexpected disruption of pregnancy and the challenges they faced both personally, and with their maternity care. The findings reinforced need for individualised, culturally-sensitive assessment and interventions, however, raised attention to potential challenges in their delivery. Steps that could be taken to address barriers to self-management are discussed and future research directions considered. Chapter two presents a qualitative research study that explores the lived experiences of men who had T2DM, low mood and diabetic complications. Interpretative Phenomenological Analysis provided opportunity to gain a deep insight into complexity in the men’s experiences, with many conceptualising early life experiences as negatively influencing diabetes self-care and help seeking. Implications for clinical practice and future research are discussed. Chapter three offers a personal reflection of the author’s experience over the course of the research, from research design to steep learning curves. The author considers the personal meaning of the research and their development as both researcher and clinician