Diet and lifestyle in type 2 diabetes: The patient's perspective

Abstract

Patient compliance with diet, lifestyle and medication regimens is an essential part of the management of type 2 diabetes mellitus. Issues and barriers relating to patient compliance were investigated in group discussions with a total of 123 patients with type 2 diabetes in four European countries and the USA. Patients were found to be well motivated to comply with advice on diet and lifestyle, but many felt they had received insufficient information about their disease and prescribed treatments. In addition, patients often felt that the reasons behind the lifestyle and dietary advice had not been adequately explained, and that dietary advice was vague. Consequently, patients' understanding of the reasons for the changes they believed they had to make was often poor, and they found some lifestyle changes difficult to make. Eating at regular times, not missing meals, reducing alcohol intake or favourite foods, and taking tablets at the same time each day without fail were all directives where a degree of non-compliance was admitted. There was confusion between diet and lifestyle changes aimed at improving metabolic control and risk profile, and those required to offset the risk of hypoglycaemia inherent in some antidiabetic therapies (e.g. long-acting sulphonylureas), such as eating meals at set times. It is unfortunate that, by imposing additional diet and lifestyle restrictions, such hypoglycaemic therapies compromise patients' lifestyles and divert their energy and commitments from genuinely beneficial behaviour changes. Copyright © 2002 John Wiley & Sons, Ltd.