My Voice: A Grounded Theory Analysis of the Lived Experience of Type 2 Diabetes in Adolescence

Objectives: The aims of this study were to (1) describe the lived experiences of youth with type 2 diabetes from the perspectives of youth, their primary caregivers and healthcare professionals; (2) explore the barriers and facilitators to adopting lifestyle approaches for diabetes self-management; and (3) generate a relevant grounded theory. Methods: This qualitative study was based on a grounded theory framework and consisted of interviews and focus groups with youth with type 2 diabetes (n=8), their primary caregivers (n=6) and healthcare professionals (n=8). Youth and their primary caregivers were purposely selected to represent extremes of successful self-management through lifestyle therapy. Focus groups were held with healthcare professionals (allied health [n=5]; pediatric endocrinologists [n=3]) in an effort to triangulate responses with youth and their primary caregivers. Results: Youth with type 2 diabetes, their primary caregivers and their healthcare professionals described supportive relationships as being important determinants of adopting healthful-living self-management behaviours. All 3 groups also recognized that social determinants of health (i.e. food insecurity, poverty) were significant barriers to adopting healthful living behaviours for families with youth who have type 2 diabetes. Healthcare professionals recognized that the barriers to self- management were different for youth with type 2 diabetes than for youth with type 1 diabetes and felt that families would benefit from a clinic dedicated to meet their unique needs. Conclusions: Supportive relationships and social determinants of health are perceived as being significant determinants of the adoption of healthful behaviours by youth with type 2 diabetes and should be considered in clinical management and future therapeutic trials. (C) 2014 Canadian Diabetes Association