Food habits of people with type 2 diabetes.

摘要

The purpose of this research was to identify the food habits of people with type 2 diabetes and relate these habits to their level of glycemic control and experiences with diabetes. Site-based recruitment ensured that the participants represented the socioeconomic differences found among people with diabetes. Eighty-nine individuals diagnosed with type 2 diabetes >1 year and between the ages of 40–65 years (55 women, 43 African Americans, and 49 lower income individuals) comprised the sample. Data collection included interviews exploring a range of topics related to diabetes and its treatment. Each participant provided hemoglobin A_1c (HbA_1c), demographic information, and treatment history. The data addressed each of the three research phases.; Phase I identified the food habits of people with type 2 diabetes and related these habits to glycemic control. Using qualitative analysis techniques and multivariate analyses, a four factor solution (Basic Eating Principles, Meal Planning, Carbohydrate Management and Challenges of Dining Out) derived from 15 food habits explained 51.5% of the total variance in HbA_1c values. Similar patterns across the 15 food habits identified four participant clusters that differed on HbA_1c ( Health Eating Lifestyle, Disciplined Eating Approach, Limited Dietary Focus , and Poor Dietary Management.); Phase II described the 15 food habits and participants' adaptation of their eating habits to diabetes requirements. The food habits represented meals eaten inside and outside the home and reflected ways to conveniently add healthful foods to the diet. Four barriers to establishing healthy eating habits were identified—Eating Pleasure, Craving Food, Burden of a Healthful Diet, and Eating Convenience.; Phase III examined how individuals on either end of glycemic control differed in their views of diabetes and examined the influence of lifecourse experiences and explanatory models of illness on self-management. Five participant categories (Committed, Tentative, Hopeful, Hassled, and Overwhelmed) were identified based upon variations in beliefs about diabetes and its treatment and parallel life histories. Participants' profiles illustrated how life experiences and peoples' explanatory models are linked to diabetes self-management.; These results demonstrate the complex nature of diabetes dietary practices and the need to consider individual differences when designing programs to improve glycemic control.