The experiences of people with Type 2 diabetes (T2DM) who recently induced remission by low-carbohydrate diets (LCDs) in primary care settings
Year: 2024
Type: article
Abstract: Low-carbohydrate diets (LCDs) can be effective in inducing Type 2 diabetes (T2DM) remission(1). Although there are large interventional studies conducted on quantitative outcomes for remission, qualitative aspects -primarily patient experiences- are less likely to be explored. This study aimed to investigate experiences of participants who recently induced remission using a LCD in primary care. Participants were recruited from two GP practices in England after receiving advice to follow a LCD by their GP and recently achieved T2DM remission. Semi-structured interviews were performed virtually, audio recorded and transcribed. The interview questions focussed on barriers and facilitators when adopting a new diet and lifestyle for inducing remission. Verbatim transcripts were analysed using Braun&Clarke’s(2) guide. Ethical approval was granted from Edge Hill University and the NHS (ETH2122-0228 and 22/SC/0451, respectively). Twelve participants (4 female/8 male) completed the study. Mean ( ± SD) age of participants was 69 ± 8 years. Duration of T2DM prior to remission was 66 ± 54 months. Mean ( ± SD) HbA1c was 44 ± 2 mmol/mol. Thematic analysis yielded four overarching themes: 1) motivation, 2) empowerment and autonomy,3) challenges and 4) integrating LCD into daily life. The analysis indicated that a behaviour change in participants was observed as evidenced by theme 4 integrating LCD into daily lives. In this theme, participants mentioned they built new habits such as reading food labels and cooking fresh meals, with new and more mindful attitudes towards food. Especially on days where they deviated from LCD, usually due to social events, they strived for balance and continued to follow LCD the next day. “I just went for it. I just ate everything that was there. I sort of a budgeted in my head. So, OK, let’s go for this. This is for your birthday and enjoy it. Embrace it and then back to it tomorrow. Back to sensible eating tomorrow. I’m really proud of myself for what I’ve achieved so far. But you know when those moments come, I’ll probably just go with it.” P01 The findings aligned with a UK study(3) where participants who followed LCD found enjoyment in their food and they viewed LCD as a lifestyle change rather than a short-term fix, as well as allowing for some flexibility (striving for balance) within LCD. These factors were similarly observed in our study, and this facilitated adherence to LCD. This study suggests that LCD advice by GPs was well-received by patients and was associated with positive lifestyle changes. Participants report that having some flexibility with LCD, such as taking breaks for special occasions, aided long term compliance. Initiatives that aim to encourage long-term compliance need to consider the importance of flexible management allowing participants to plan and recover from relapse.
Authors: A.N. Aksoy, J. Abayomi, N. Relph, T. Butler
Institution: Edge Hill University
Language: English
Topic: Diet and metabolism studies
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4405450906