Background. Despite the fact that there is an increasingly effective armoury of medications to treat diabetes, many people continue to have substantially elevated blood glucose levels. The purpose of this study was to explore what the barriers to diabetes management are in a cohort of people with diabetes and poor glycaemic control. Methods. Qualitative semistructured interviews were carried out with 10 people with diabetes who had known diabetes and a recent HbA1c of >11.3% (100 mmol/mol) to explore their experiences of barriers to diabetes self-management and glycaemic control. Results. Barriers to diabetes management were based around two key themes: biopsychosocial factors and knowledge about diabetes. Specifically, financial concerns, social stigma, medication side effects, and cognitive impairment due to hyperglycaemia were commonly reported as barriers to medication use. Other barriers included a lack of knowledge about their own condition, poor relationships with healthcare professionals, and a lack of relevant resources to support diet and weight loss. Conclusion. People with diabetes with poor glycaemic control experience many of the same barriers as those reported elsewhere, but also experience issues specifically related to their severe hyperglycaemia. Management of diabetes could be improved via the increased use of patient education and availability of locally relevant resources.

中文翻译：

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新西兰 2 型糖尿病和血糖控制不佳成人亚群糖尿病自我管理的障碍

背景。尽管治疗糖尿病的药物越来越有效，但许多人的血糖水平仍然显着升高。本研究的目的是探讨在一组糖尿病患者和血糖控制不佳的人群中，糖尿病管理的障碍是什么。方法。对 10 名已知糖尿病且近期 HbA1c > 11.3% (100 mmol/mol) 的糖尿病患者进行了定性半结构化访谈，以探讨他们在糖尿病自我管理和血糖控制方面遇到障碍的经历。结果. 糖尿病管理的障碍基于两个关键主题：生物心理社会因素和糖尿病知识。具体而言，财务问题、社会污名、药物副作用和高血糖引起的认知障碍通常被报告为药物使用的障碍。其他障碍包括缺乏对自身状况的了解、与医疗保健专业人员的关系不佳以及缺乏支持饮食和减肥的相关资源。结论. 血糖控制不佳的糖尿病患者会遇到许多与其他地方报道的相同的障碍，但也会遇到与严重高血糖症特别相关的问题。通过增加对患者教育的使用和当地相关资源的可用性，可以改善糖尿病的管理。