Abstract
The purpose of this consensus conference was to have a lay panel of persons with type 2 diabetes (T2D) work in collaboration with an expert panel of diabetes professionals to develop strategies designed to improve dietary and physical activity adherence in persons with T2D. Lay panel participants were 15 people living with T2D. The seven experts had expertise in exercise management, cardiovascular risk factors, community-based lifestyle interventions, healthy weight strategies, the glycemic index, exercise motivation, and social, environmental and cultural interactions. All meetings were facilitated by a professional, neutral facilitator. During the conference each expert gave a 15-min presentation answering questions developed by the lay panel and all panel members worked to generate suggestions for programs and ways in which the needs of persons with T2D may be better met. A subgroup of the lay panel used the suggestions created from the conference to generate a final list of recommendations. Recommendations were categorized into (1) diagnosis/awareness (e.g., increasing awareness about T2D in the general public, need for lifelong self-monitoring post-diagnosis); (2) education for the person with diabetes (e.g., periodic “refresher” courses), professionals (e.g., regular interactions between researchers and persons with T2D so researchers better understand the needs of the affected population), and the community (e.g., support for families and employers); and (3) ongoing support (e.g., peer support groups). The recommendations from the conference can be used by researchers to design and evaluate physical activity and nutrition programs. The results can also be of use to policy makers and health promoters interested in increasing adherence to physical activity and nutrition guidelines among persons with T2D.
Highlights
The prevalence of diabetes in Canada is increasing, doubling within the Canadian province of Alberta between 1997 and 2007 to a rate of 4.5% (Johnson and Balko, 2009)
Popular views suggest that diet and physical activity choices are primarily controlled by the individual, the role of interpersonal and environmental factors in the dietary and physical activity choices people make are increasingly recognized (Johnson and Balko, 2009)
It was perceived that health care providers had little credibility because they don’t know what it’s like to have the disease. These findings suggest that intervention development for dietary and physical activity adherence must include both client and expert perspectives
Summary
The prevalence of diabetes in Canada is increasing, doubling within the Canadian province of Alberta between 1997 and 2007 to a rate of 4.5% (Johnson and Balko, 2009). Healthy self-management practices such as following a recommended diet, regular physical activity, appropriate medication use, self-monitoring of blood glucose, and smoking cessation (Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, 2008), can be successful (Minet et al, 2010) and are cost-effective from a payer perspective over 10 years (The Diabetes Prevention Program Research Group, 2012). The clinical practice guidelines from the Canadian Diabetes Association Clinical Practice Guidelines Expert Committee (2008) provide physical activity and nutrition behavior recommendations. They do not address how the recommendations may be achieved. Popular views suggest that diet and physical activity choices are primarily controlled by the individual, the role of interpersonal and environmental factors in the dietary and physical activity choices people make are increasingly recognized (Johnson and Balko, 2009)
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