BACKGROUND In 2017, 425 million adults worldwide had diabetes; 80% were living in low and middle-income countries. Bangladesh had 6.9 million adults with diabetes; death from diabetes comprised 3% of the country's total mortality. This study looked at different factors (personal, familial, social, and financial) affecting both the life of patients with diabetes type 2 and the management of the disease. It also explored patient's perception of the mobile health intervention in the context of disease management and helped to explain the findings obtained from the quantitative part of this study. METHOD The study was a mixed-method, sequential explanatory design. A mobile health project (interactive voice call and call center) was implemented in Dhaka district, Bangladesh from January to December, 2014. Patients received treatment at the outpatient department of Bangladesh Institute of Health Science Hospital, Dhaka, Bangladesh, were included in intervention and control groups of the main study following a Randomized Control Trial. Among them, a total of 18 patients (9 + 9) were selected purposefully for the qualitative study, which was conducted in July, 2015. The sample was selected purposefully considering the age, sex, socio-economic status and proximity of living due to the political instability of the country during the data collection period. The interviews were transcribed and analyzed applying investigator triangulation. RESULTS Most patients stated that diabetes has affected their lives. In general, both groups´ evaluation of mobile health services were good and both regarded the recommendations for medication, diet, physical exercise, and other lifestyle behaviors (use of tobacco and betel nuts) as helpful. The cost of overall treatment (medications, physician consultations, laboratory investigations), the lack of availability of safe public places for physical exercise and unfavorable weather conditions (heat, rainfall) were mentioned as barriers to the overall management of the disease. CONCLUSION A patient-centered mobile health intervention supported by a collaborative patient-provider relationship, a strong family support system, available public spaces for exercise and the introduction of a functional public health insurance system could be beneficial for the better management of diabetes.

中文翻译：

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了解 2 型糖尿病患者的生活经历和有效的疾病管理：孟加拉国移动健康干预后的一项定性研究。

背景 2017 年，全球有 4.25 亿成年人患有糖尿病；80%生活在低收入和中等收入国家。孟加拉国有 690 万成年人患有糖尿病；糖尿病死亡人数占该国总死亡率的3%。这项研究着眼于影响 2 型糖尿病患者生活和疾病管理的不同因素（个人、家庭、社会和财务）。它还探讨了患者在疾病管理背景下对移动健康干预的看法，并有助于解释从本研究的定量部分获得的结果。方法 该研究采用混合方法、序贯解释性设计。2014年1月至12月，孟加拉国达卡地区实施移动医疗项目（交互式语音呼叫和呼叫中心）。患者在孟加拉国达卡健康科学研究所医院门诊部接受治疗，纳入干预和治疗范围。随机对照试验后主要研究的对照组。其中，特意选择了 18 名患者（9+9）进行定性研究，该研究于 2015 年 7 月进行。样本的选择考虑了年龄、性别、社会经济状况和居住地接近程度，因为数据收集期间该国的政治不稳定。应用研究者三角测量对访谈进行转录和分析。结果 大多数患者表示糖尿病已经影响了他们的生活。总体而言，两组对移动医疗服务的评价都很好，并且都认为药物、饮食、体育锻炼和其他生活方式行为（使用烟草和槟榔）的建议有帮助。总体治疗费用（药物、医生咨询、实验室检查）、缺乏安全的公共场所进行体育锻炼以及不利的天气条件（炎热、降雨）被认为是对该疾病进行总体管理的障碍。结论 以患者为中心的移动健康干预措施，由患者与提供者协作关系、强大的家庭支持系统、可用的公共锻炼空间以及功能性公共健康保险体系的引入所支持，可能有利于更好地管理糖尿病。