Exploring Experiences, Barriers, and Needs in Medication and Dietary Adherence among Type 2 Diabetes Patients: Qualitative Study
DOI:
https://doi.org/10.67963/jiken.v2i4.80Keywords:
Diabetes Mellitus, Type 2, Diet, Medication Adherence, Patient-Centered Care, Qualitative ResearchAbstract
Background: Type 2 diabetes requires sustained medication use and dietary modification, yet adherence is disrupted by treatment burden, family routines, food practices, financial constraints, and interpretations of illness. Understanding these interacting influences is essential for feasible patient-centred care.
Research Objective: This study aimed to explore patients’ experiences of medication and dietary adherence, identify perceived barriers, and describe the support needed for sustainable self-management.
Methods: A qualitative descriptive study was conducted at Sandi Karsa Hospital from January to March 2026. Twenty-six people with type 2 diabetes were recruited through purposive sampling. Data were collected through face-to-face semi-structured interviews. Transcripts were analysed thematically. Credibility was supported through member checking, peer discussion, reflexive notes, and an audit trail. Data saturation occurred by interview 23 and was confirmed through three interviews.
Results: Five themes were identified: interpreting adherence through bodily experiences; managing practical medication barriers; negotiating dietary recommendations in family and social life; developing adherence strategies; and expecting individualised care. Participants sometimes adjusted medication according to symptoms, concerns about adverse effects, or disrupted routines. Dietary adherence was constrained by family meals, food costs, and social obligations. Medication routines, family reminders, affordable dietary guidance, and professional communication facilitated adherence.
Conclusion: Medication and dietary adherence were interconnected behaviours shaped by personal, relational, economic, and healthcare conditions. Sandi Karsa Hospital should implement family-inclusive counselling involving physicians, nurses, pharmacists, and nutritionists. Care should address treatment concerns, simplify routines, and provide culturally appropriate dietary recommendations.
Downloads
References
Alnahdi, H., Alghamdi, R., Alyamani, S., Taha, S., Rayes, R., Almadani, A., Yassin, H., Alhamed, L., Alhozali, A. M., & Alfares, K. (2025). Diabetes management: Self-management education and support program evaluations in Jeddah, KSA. Journal of Taibah University Medical Sciences, 20(4), 507–516. https://doi.org/https://doi.org/10.1016/j.jtumed.2025.07.005
Alsayed, A. O., Ismail, N. A., Hasan, L., Syed, A. H., Embarak, F., & Da’u, A. (2023). A systematic literature review for understanding the effectiveness of advanced techniques in diabetes self-care management. Alexandria Engineering Journal, 79, 274–295. https://doi.org/https://doi.org/10.1016/j.aej.2023.08.026
Alyami, M., Serlachius, A., Law, M., Murphy, R., Almigbal, T. H., Lyndon, M., Batais, M. A., Algaw, R. K., & Broadbent, E. (2022). Utility and Acceptability of a Brief Type 2 Diabetes Visual Animation: Mixed Methods Feasibility Study. JMIR Formative Research, 6(8). https://doi.org/https://doi.org/10.2196/35079
Buss, V. H., Varnfield, M., Harris, M., & Barr, M. (2022). A Mobile App for Prevention of Cardiovascular Disease and Type 2 Diabetes Mellitus: Development and Usability Study. JMIR Human Factors, 9(2). https://doi.org/https://doi.org/10.2196/35065
Chauke, G. D., Nakwafila, O., Chibi, B., Sartorius, B., & Mashamba-Thompson, T. (2022). Factors influencing poor medication adherence amongst patients with chronic disease in low-and-middle-income countries: A systematic scoping review. Heliyon, 8(6), e09716. https://doi.org/https://doi.org/10.1016/j.heliyon.2022.e09716
Eisinger, F., Holderried, F., Mahling, M., Stegemann–Philipps, C., Herrmann–Werner, A., Nazarenus, E., Sonanini, A., Guthoff, M., Eickhoff, C., & Holderried, M. (2025). What’s Going On With Me and How Can I Better Manage My Health? The Potential of GPT-4 to Transform Discharge Letters Into Patient-Centered Letters to Enhance Patient Safety: Prospective, Exploratory Study. Journal of Medical Internet Research, 27. https://doi.org/https://doi.org/10.2196/67143
Griauzde, D. H., Ling, G., Wray, D., DeJonckheere, M., Mizokami Stout, K., Saslow, L. R., Fenske, J., Serlin, D., Stonebraker, S., Nisha, T., Barry, C., Pop-Busui, R., Sen, A., & Richardson, C. R. (2022). Continuous Glucose Monitoring With Low-Carbohydrate Nutritional Coaching to Improve Type 2 Diabetes Control: Randomized Quality Improvement Program. Journal of Medical Internet Research, 24(2). https://doi.org/https://doi.org/10.2196/31184
Hu, L., Jin, X., Li, Y., Wang, H., Yang, D., Zhang, Z., He, X., Liao, J., Chen, W., & Gong, N. (2023). Perspective of People With Type 2 Diabetes Toward Self-management: Qualitative Study Based on Web Crawler Data. Journal of Medical Internet Research, 25. https://doi.org/https://doi.org/10.2196/39325
Khalil, S. H. A., Khaled, M., Zakhary, R., & Shereen, M. (2024). The Rate of Insulin use and Suboptimal Glycemic Control among Egyptian Patients with T2DM: Cohort Analysis of Eighth Wave of the International Diabetes Management Practices Study (IDMPS). Current Diabetes Reviews, 20(3). https://doi.org/https://doi.org/10.2174/1573399820666230602100629
Kongsa, A., Thongsri, P., Chiangkhong, A., & Chongjarearn, A. (2024). Perceptions of Medication Adherence among Elderly Patients with Hypertension in Bangkok: A Qualitative Study. The Open Public Health Journal, 17. https://doi.org/https://doi.org/10.2174/0118749445280796240206102656
Kwakye, I. N. (2025). Exploring the interpretive processes of symptom perception among diabetes patients in eastern region of Ghana. Dialogues in Health, 7, 100260. https://doi.org/https://doi.org/10.1016/j.dialog.2025.100260
Mira-Martínez, S., Malih, N., Angullo-Martínez, E., Zamanillo-Campos, R., Yañez, A. M., Bennasar-Veny, M., Gómez-Juanes, R., Konieczna, J., Jiménez, R., Serrano-Ripoll, M. J., Fiol-deRoque, M. A., Leiva, A., Galmes-Panades, A. M., Miralles-Xamena, J., Vidal-Thomàs, M. C., Gómez-Cobo, C., Gervilla, E., Oña-Gil, J. I., & Ricci-Cabello, I. (2025). A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial. Journal of Medical Internet Research, 27. https://doi.org/https://doi.org/10.2196/70981
Mondoh, A., Craig, H., Crotty, M., Contreras, F., & le Roux, C. W. (2025). How do patients choose between obesity medications: A thematic analysis. Obesity Pillars, 15, 100187. https://doi.org/https://doi.org/10.1016/j.obpill.2025.100187
Montilva-Monsalve, J., Dimantas, B., Perski, O., & Gutman, L. M. (2023). Barriers and Enablers to the Adoption of a Healthier Diet Using an App: Qualitative Interview Study With Patients With Type 2 Diabetes Mellitus. JMIR Diabetes, 8. https://doi.org/https://doi.org/10.2196/49097
Okazaki, K., Takahashi, N., Shingaki, T., Perez-Nieves, M., & Stuckey, H. (2022). Key factors for overcoming psychological insulin resistance: A qualitative study in Japanese people with type 2 diabetes. Primary Care Diabetes, 16(3), 411–416. https://doi.org/https://doi.org/10.1016/j.pcd.2022.02.009
Omonaiye, O., Mekonnen, A., Gilfillan, C., Wong, R., Rasmussen, B., Holmes-Truscott, E., Namara, K. M., Manias, E., Lai, J., & Considine, J. (2025). Evaluation of diabetes mellitus medication-taking behavior among first- and second-generation Australians of Chinese heritage: A nationwide cross-sectional study. Exploratory Research in Clinical and Social Pharmacy, 18, 100600. https://doi.org/https://doi.org/10.1016/j.rcsop.2025.100600
Orozco-Beltrán, D., Morales, C., Artola-Menéndez, S., Brotons, C., Carrascosa, S., González, C., Baro, Ó., Aliaga, A., Ferreira de Campos, K., Villarejo, M., Hurtado, C., Álvarez-Ortega, C., Gómez-García, A., Cedenilla, M., & Fernández, G. (2022). Effects of a Digital Patient Empowerment and Communication Tool on Metabolic Control in People With Type 2 Diabetes: The DeMpower Multicenter Ambispective Study. JMIR Diabetes, 7(4). https://doi.org/https://doi.org/10.2196/40377
Parikh, R., Bhargava, Y., & Shukla, A. (2024). Gestational Diabetes and Poor Healthcare Affordability Among Pregnant Women: A Double Whammy! Procedia Computer Science, 235, 767–778. https://doi.org/https://doi.org/10.1016/j.procs.2024.04.073
Seiglie, J., Tobolsky, S., Crespo Trevino, R., Cordova, L., Cromer, S., Caballero, A. E., Alegria, M., Miranda, J. J., Wexler, D., & Mayberry, L. (2025). Adapting a Text Messaging Intervention to Improve Diabetes Medication Adherence in a Spanish-Speaking Population: Qualitative Study. JMIR Human Factors, 12. https://doi.org/https://doi.org/10.2196/66668
Sharifi, Z., Soleimani, Z., Mahini, S. M., Nejabat, M., & Molavi Vardanjani, H. (2024). Assessment of multidimensionality determinants of eye care adherence among type 2 diabetic patients in Shiraz, Iran. Clinical Epidemiology and Global Health, 29, 101679. https://doi.org/https://doi.org/10.1016/j.cegh.2024.101679
Singh, J., Sangwan, R. K., Mudgal, S. K., & Huda, R. K. (2025). Empowering diabetes care: Patient practices and the role of mobile health – A qualitative exploration. Dialogues in Health, 7, 100231. https://doi.org/https://doi.org/10.1016/j.dialog.2025.100231
Sriraman, S., Sreejith, D., Andrew, E., Okello, I., & Willcox, M. (2023). Use of herbal medicines for the management of type 2 diabetes: A systematic review of qualitative studies. Complementary Therapies in Clinical Practice, 53, 101808. https://doi.org/https://doi.org/10.1016/j.ctcp.2023.101808
Ye, Q., Xu, R., Li, L., Zhao, M., Wang, S., Peng, S., Chen, S., Ahmed, F., Wu, C., & Wang, K. (2025). The Dual Impact of Time and Content Exposure of Social Media on Diabetes Self-Management in Older Adults: Cross-Sectional Study. JMIR Aging, 8. https://doi.org/https://doi.org/10.2196/67312
Zhang, P., Tao, X., Ma, Y., Zhang, Y., Ma, X., Song, H., Liu, Y., Patel, A., Jan, S., & Peiris, D. (2024). Improving the management of type 2 diabetes in China using a multifaceted digital health intervention in primary health care: the SMARTDiabetes cluster randomised controlled trial. The Lancet Regional Health - Western Pacific, 49, 101130. https://doi.org/https://doi.org/10.1016/j.lanwpc.2024.101130
Zhang, Y., Han, H., & Chu, L. (2022). Effectiveness of restricted diet with a plate in patients with type 2 diabetes: A randomized controlled trial. Primary Care Diabetes, 16(3), 368–374. https://doi.org/https://doi.org/10.1016/j.pcd.2022.03.007
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.







