Experiences of midlife and older African American men living with type 2 diabetes

ABSTRACT

Objective

Type 2 Diabetes Mellitus (T2DM) is a complicated disease that disproportionately affects African American men. Understanding the experiences of African American men living with T2DM is important for developing effective, culturally sensitive interventions. The purpose of this study was to describe how African American men view their T2DM and describe their perspectives on living with and self-managing T2DM.

Design

In-depth semi-structured qualitative interviews were conducted with 22 African American men aged 40–85 years diagnosed with T2DM. Interviews were transcribed and analyzed using NVivo 10 with thematic analysis.

Results

Disbelief, shock, and denial were commonly experienced reactions at initial diagnosis. Many participants defined diabetes using words such as ‘sugar’ or ‘glucose’ and reported an awareness of health complications caused by diabetes, such as amputations and diabetic comas. Participants expressed various perspectives and attitudes towards having diabetes, including avoidance/apathy, fatalism, guilt and shame, fear and concern, and self-mastery. The majority of men described efforts to self-manage diabetes via glucose monitoring, changing dietary habits, and exercise. Many participants expressed concern over the financial burden associated with managing diabetes and reported that high costs can hinder a patient’s ability to maintain active self-monitoring and deter patients from attending needed doctor’s visits. Many participants expressed confidence in their healthcare providers, although a few expressed feelings of distrust and being uninformed. Participants tended to most appreciate physicians who spent time discussing their condition and who made an effort to engage in open patient-provider communication.

Conclusion

Living with diabetes can be emotionally, physically, and mentally challenging. Efforts to improve adoption and maintenance of self-management behaviors may benefit from sensitivity to the patient’s attitude and perspectives towards diabetes self-management, assistance overcoming the financial burden of managing diabetes, and open patient-provider communication.

KEYWORDS:

• Type 2 diabetes mellitus
• African American men
• self-management
• glucose monitoring
• dietary change
• patient-provider communication

Acknowledgments

The following people and organization assisted with recruitment of participants; Bishop Kenneth Monroe Presiding Prelate of the Eastern North Carolina Episcopal District of the AME Zion Church. The Rock Hill District of the South Atlantic Episcopal District of the AME Zion Church; Rev. Hanna Broome, M.Div.

Disclosure statement

No potential conflict of interest was reported by the author(s).