Diabetes and diet: Managing dietary barriers.

This thesis reports on the barriers diabetic patients experience with their diet, and the ways they cope with these barriers. A dietary barrier is a hinderance to a person's well-being, induced by being advised a diet. First inventories were made of possible dietary barriers and ways of coping with them. Secondly the prevalence of these barriers and ways of coping with them were assessed among different diabetic populations. Most prevalent were barriers expressing physical discomfort and restrictions in food-use. Barriers with the highest prevalence were most often dealt with by non-compliance.The prevalence of barriers among recently diagnosed diabetics did not differ from prevalences after a follow-up period of one year. It was concluded that dietary barriers are not easily overcome by diabetic patients. Hardly any differences were found in barrier prevalence when comparing insulin- treated and non insulin-treated diabetic patients. Prevalence of barriers among diabetics with conventional insulin therapy was higher when compared to diabetics with continuous subcutaneous insulin infusion and a liberalized diet.It is concluded that diets allowing for variability in energy-intake and meal-times will decrease prevalence of dietary barriers among diabetics. Also barrier prevalence could decrease when the diet is not perceived as consisting of forbidden foods. Diets leading to less dietary barriers are not only more pleasurable to live with, such diets also are more likely to be adhered to.<TT>