Barriers to T2D Complications: Research Findings and Implications

This article discusses the barriers related to Type 2 Diabetes (T2D) complications and their implications for diabetes care. It presents the research findings from various studies that have explored these barriers and their impact on T2D self-management. The article also highlights the themes that have emerged from the research and provides critical insights from the perspective of a researcher. The findings of these studies can help healthcare providers personalize diabetes care services and implement culturally appropriate interventions for T2D patients.

ARTICLE THEORY(S) METHODOLOGY/
METHODS
METHODOLOGY/
METHODS
RESULTS/
FINDINGS
REPORTED
POSSIBLE
THEMES
EMERGING
MY VOICE AND
CRITICAL
VIEWAS A
RESEARCHER
Author
Date and Source
(using Harvard
referencing
system)
Aims:
Any theoretical
points? Any particular
epistemological
approach
Are the authors using
Positivist theories?
Phenomenological
theories?
Social constructionist
theories?
Critical theory?
Any
research question
(s)?
What are the research
methods used?
Qualitative: tools?
Design?
Main Results or
Outcomes
achieved by the
research?
Theme (s) Any critical
comments about the
theoretical points?
Research methods?
Results
Findings?
Any research
implications for your
change in practice?
Sina, Graffy and
Simmons (2018)
To determine
the barriers
related to T2D
complications
Phenomenological
research
What are the
barriers related to
T2D
complications?
Postal invitation to
3649 T2D patients
across 62 general
practice subjected to
Barriers-to-Diabetes-
Care Survey (BDCS)
Statistical
analysis and
grouping the
barriers into 5
categories
Major identified
were physical
health barriers,
systems barriers,
psychological
barriers, financial
difficulties,
presence of
comorbidities ,
feeling worried,
and lack of
readiness
No causal-
relationship was
established.
Systematic
identification of
the barriers will
help in
personalising
diabetes care
services in future.
Booth et al.
(2013)
To determine
the perceptions
of people
diagnosed with
Phenomenological
research
What are the
barriers and
facilitators to
self-management
of exercise and
diet in T2D
6 focus group with 16
patients and semi-
structured interviews
with providers
Changing lifetime
habits, not liking
foods
recommended,
unappealing diet,
routine rigidity,
Lack of
representativeness
of patient group
and small sample
size
Barrier

T2D, with
regards to
physical activity
and dietary
intake self-
management
patients? eating different
from others, social
situations, lack of
awareness, lack of
motivation,
sufficiency of
medication, and
costs of diet
identification will
increase
understanding of
patient needs, and
refine the
intervention
strategies
Hu et al. (2013)
To discover
apparent
barriers among
Hispanic settlers
with diabetes
Phenomenological
research
What barriers are
perceived by
Hispanic
migrants and
their family, in
relation to
diabetes care?
Qualitative study with
focus groups among
73 T2D affected
Hispanic immigrants
37 family
members and
36 immigrants
were recruited
and asked
questions
Patient identified
themes- suffering
from diabetes,
lack of support
and resources, and
problem in
managing diabetes
Family identified
themes- Lack of
knowledge and
they can offer
support
Lack of
representativeness
of target
population, and
small convenience
sample reduced
reliability of
results
The barrier
recognition would
facilitate
implementation of
culturally
appropriate
intervention and
education to
diabetes patients
in future
Mogre et al.
(2019)
To explore the
healthcare
provider and
patient
Phenomenological
research
What are the
barriers to
diabetes self-care
performance
behaviour?
Semi‐structured
interviews of T2D
patients and healthcare
providers
Verbatim
transcription
followed by
thematic
analysis
Barriers include
misconception
s on diabetes,
inadequate
family
support, trouble
The research
failed to explore
perception of
diabetes patients
who do not seek
clinical care.

perspectives
about barriers to
diabetes self-
care
performance
behaviour
changing old
habits, social
stigma,
intentional non-
adherence,
cultural
beliefs, poor
income levels,
and lacking
motivation.
Identification of
the barriers would
help in addressing
them in middle
income countries
to improve
diabetes care
adherence
Tong,
Vethakkan and
Ng (2015)
To determine
the factors that
influence poor
glycemic
control in T2D
patients using
insulin
Phenomenological
research
What factors
control poor
glycemic control
in T2D patients
using insulin?
In-depth individual
interviews of 17 T2D
patients
Transcription
of in-depth
individual
interviews,
followed by
thematic
analysis
Lifestyle barriers
in showing
compliance to
medical
recommendations;
emotional and
psychosocial
hurdles;
treatment-
associated issues;
absence of
knowledge about
diabetes self-
management.
Recruitment at a
single location,
and effect of
environment
might have
created an impact
on results.
Healthcare
providers will be
able to use the
findings for
eliminating the
barriers and
patient concerns
Yasa et al.
(2018)
To determine
the barriers for
self-
management of
T2D patients in
Bali
Descriptive
phenomenology
design
What are the
barriers that
prevent diabetes
self-management
among patients in
Bali?
In-depth interviews of
10 T2D patients, aged
40-60 years
The interview
responses were
transcribed
verbatim and
thematically
analysed
Absence of
knowledge on
diabetes
management; lack
of capability to
manage glycemic
control; difficulty
in diabetes
Small sample size
reduced reliability
and validity of the
findings
Identifying these
challenges will
help in reducing
the difficulties that

management patients face in
diabetes care
Ong, Chua and
Ng (2014)
To explore the
facilitators and
barriers to blood
glucose self-
monitoring in
T2D patients
Phenomenological
research
What are the
facilitators and
barriers to blood
glucose self-
monitoring in
T2D patients
taking insulin?
Qualitative research
design with semi-
structured, individual
in-depth interviews
15 participants
were
purposively
sampled and
interviewed
until reaching a
thematic
saturation
Barriers-
frustration
connected to
elevated blood
glucose; stigma;
awareness that
SMBG occurred
due to insulin
titration; terror of
pain and needles;
costs;
unconducive
workplace;
inconvenience;
and non-existence
of knowledge and
motivation
Lack of
representativeness
of findings
Understanding
patient perception
will help providers
to deliver care in
an effective
manner
Vest et al.
(2013)
To determine
the effects of
relationship and
social support
on diabetes self-
management
Phenomenological
research
What are the
impacts of
relationship and
social support on
self-management
of diabetes?
Semi-structured
interviews
34 diabetes
patients
subjected to
interviews,
followed by
thematic
analysis
the effect of social
support networks;
nature of
association
between patient
and health system;
relationship
between doctor
and patient
Convenience
sampling, and
predominantly
female population
reduced result
reliability
Identification of
barriers will help
in effective
diabetes
management in
future
Matrix for qualitative studies