How patients adapt diabetes self-care recommendations in everyday life

J Fam Pract. 1998 Mar;46(3):207-15.


Background: Our study explored behavioral factors affecting what patients with type 2 diabetes do for self-care and why they do it. The findings were used to develop clinical recommendations to improve intervention strategies.

Methods: Interviewers, using open-ended questions, explored patients' own perceptions and assessments of self-care behaviors. The fifty-one subjects were self-identified Mexican Americans who had type 2 diabetes for at least 6 months, and had no major impairment as a result of this diabetes. Texts of patient interviews were analyzed by building and refining matrixes to display and compare central themes regarding treatment strategies and their contexts.

Results: All patients were trying to control their diabetes, but none of them followed recommendations completely. Instead, they adapted self-care behaviors to the exigencies of everyday life. Key factors influencing patients' treatment choices were: (1) the belief in the power of modern medicine; (2) the desire to act and feel "normal"; (3) the desire to avoid physical symptoms; and (4) limited economic resources.

Conclusions: As patients apply treatment recommendations in the context of their everyday lives, they continually must make many small decisions affecting self-care behavior. The specific contexts of patients' lives, including their economic, educational, and cultural circumstances, determine how the generalized principles of type 2 diabetes management are implemented. Clinical strategies must be responsive to these circumstances in order to enable patients to make appropriate decisions when adapting their self-care behaviors to their own situations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Attitude to Health
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy*
  • Diet, Diabetic
  • Female
  • Health Behavior*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Mexican Americans / psychology*
  • Middle Aged
  • Poverty*
  • Self Care* / psychology
  • Socioeconomic Factors
  • Texas


  • Blood Glucose
  • Hypoglycemic Agents