Wavering Diabetic Diet: “I Break the Diet and Then I Feel Guilty and Then I Don’t Go Back to It, In Case I Feel Guilty Again”

Abstract

This study aimed at understanding the experiences of maintaining good dietary self-care among people with type 2 diabetes mellitus and the meaning of negative emotions in the context of dietary self-care. Thirteen type 2 diabetes patients from an Endocrinology and Diabetes Department in the West Midlands region, United Kingdom, were interviewed to explore experiences of dietary self-care and negative emotions. Transcripts were analyzed using the interpretative phenomenological analysis approach. Three main themes emerged: (a) dietary self-care: a constant challenge, (b) negative emotions: a cause and a consequence, and (c) coping with negative emotions and living with “the diet.” Situations involving poor dietary self-care were identified to understand the context of negative emotions. Perceived dietary restrictions resulted in frustration, anger, and depression, while maintaining dietary self-care resulted in irritation, annoyance, regret, guilt, anger, and depression. The consequence of poor dietary self-care was frustration, depression, and anger, which further resulted in poor dietary self-care, creating a cycle of poor dietary self-care and negative emotions. This reflected the wavering nature of participants’ dietary maintenance. Coping with these negative emotions and poor dietary self-care involved rationalizing and/or acknowledging the importance of maintaining good dietary self-care. Findings showed negative emotions are perceived to impact dietary self-care and diabetes control. Health care providers should incorporate the understanding of experiences of negative emotions in dietary education and cognitive behavioral interventions should be offered to manage negative emotions.