"Respecting diabetes": Low-income Black women locating the relative importance of type II diabetes

Black women are disproportionately at risk for type II diabetes-related complications and fatality. Lifestyle changes are prescribed to treat diabetes and prevent complications, yet are demonstrably difficult to follow. This research illustrates how, for some Black women with type II diabetes, challenges following lifestyle changes may be related to locating the importance of diabetes relative to a number of significant and stressful life events and conditions with diabetes' relative importance influencing priority of diabetes self-care activities and potentially serving to reinforce disparity in diabetes-related complications. This research explored how 15 low-income Black women recently diagnosed with type II diabetes experienced their first one to three years after diagnosis. Each woman completed three qualitative interviews over nine months. Interview data were analyzed using the constant comparative method and revealed that women differed in the importance they ascribed to diabetes, characterized by three major categories: (1)“giving diabetes a lot of respect” as a serious illness demanding extensive lifestyle changes, (2) diabetes as important to manage but “not letting diabetes dominate” life, and (3) diabetes as just another of many other challenging life experiences, with self-care prioritized accordingly. Participants located the importance of diabetes in relation to previous/coexisting illnesses, serious life events, daily life responsibilities and circumstances and conditions dependent on healthy functioning (e.g. maintaining custody of grandchildren). Public health professionals working with similar populations should strive to understand the complexity of how Black women prioritize their diabetes and would find it useful to identify external diabetes-dependent conditions affecting diabetes self-care priority.