Interrupted Lives: An Exploratory Study of Self-Management of Diabetes Mellitus among African American Women

Among African Americans, behaviors and beliefs about management of disease constitute an important component of diabetes mellitus self-management. This study investigated divergence and convergence of patients' beliefs and behaviors with recommendations by diabetes educators. Twenty-five, community-dwelling, African American women age 46-87 with diabetes mellitus, completed semi-structured, in-depth interviews, a diabetes self-management questionnaire, and a demographic profile. Participants were asked about nutritional changes, physical activity, medication use, blood glucose monitoring, physician-patient interaction, support systems, and patient education/knowledge. Women reported exercise, medications, and dietary modifications as core components of diabetes self-management. Successful self-management depended upon beliefs, types of behavioral strategies utilized and available support. Barriers to access, costs of medications, testing supplies, pain, and referral to classes were among factors contributing to interrupted lives in diabetes self-management. Findings indicate that socio-cultural, structural and environmental factors support or impede participants' self-management of clinically recommended behaviors producing models of interruption to the self-management regimen.