The aim is to synthesize the most contemporary qualitative research on the self-management of type 2 diabetes with specific interest in the population of Pakistan and Saudi Arabia. The electronic databases searched include the Cochrane library, MEDLINE, PubMed, EMBASE and PsycINFO, between the year 1993 and 2013. The inclusion criteria was the middle-aged population aged 40 – 60 years. Studies must report qualitative research on diabetes self-management, diabetic complications, quality of life, and patient-doctor relationship or interaction. Out of the 36 identified studies, 30 studies from the literature search representing self-management in context suggest that the multiple contextual factors identified are the fertile ground for further research, and the context which is useful for health care professionals suggests that coping with diagnosis and living with diabetes are affected by a complex constellation of factors, including life circumstances, social support, gender roles and economy. Three conceptual themes were identified from the analysis. The review has revealed that there is a lack of studies in literature on self-management of type 2 diabetes in both the countries.
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|||American Diabetes Association (2006) Standards of Medical Care in Diabetes. Diabetes Care, 29, S4-S42.|
|||Rayappa, P.H., Raju, K.N.M., Kapur, A., et al. (1998) The Impact of Socio-Economic Factors on Diabetes Care. International Journal of Diabetes in Developing Countries, 19, 7-15.|
|||Thille, P., Ward, N. and Russell, G. (2014) Self-Management Support in Primary Care: Enactments, Disruptions, and conversational Consequences. Social Science and Medicine, 108, 97-105.
|||Goldman, J.B. and Maclean, H.M. (1998) The Significance of Identity in the Adjustment to Diabetes among Insulin Users. Diabetes Educator, 24, 741-748. http://dx.doi.org/10.1177/014572179802400610|
|||Paterson, B.L., Thorne, S.E., Canam, C., et al. (2001) Meta-Study of Qualitative Research: A Practical Guide to Meta-Analysis and Meta-Synthesis. Thousand Oaks, Sage.|
|||Gomersall, T., Madill, A. and Summers, L.K.M. (2011) A Meta-Synthesis of the Self-Management of Type 2 Diabetes. Qualitative Health Research, 21, 853-871. http://dx.doi.org/10.1177/1049732311402096|
|||Rafique, G. and Shaikh, F. (2006) Identifying Needs and Barriers to Diabetes Education in Patients with Diabetes. Journal of Pakistan Medical Association, 56, 347-352.|
|||Shaikh, B.T., Rabbani, F., Safi, N., et al. (2010) Contracting of Primary Health Care Services in Pakistan: Is Up-Scaling a Pragmatic Thinking? Journal of Pakistan Medical Association, 60, 386-389.|
|||World Bank, Pakistan (2002) Poverty Assessment. Poverty in Pakistan: Vulnerabilities, Social Gaps, and Rural Dynamics. Poverty Reduction and Economic Management Sector Unit South Asia Region, 2002.|
|||Government of Pakistan (2000) Utilization of Public Health Facilities in Pakistan. National Health Management Information System, Islamabad.|
|||National Institute of Population Studies (2008) Pakistan Demographic and Health Survey 2006-07 Final Report. Islamabad.|
|||Nishtar, S. (2006) The Public-Private Interface: More than “a Driver of Economic Growth”. Viewpoint, Pakistan Health Policy Forum, Heartfile, Islamabad.|
|||Peters, A.L., Legorreta, A.P., Ossorio, R.C. and Davidson, M.B. (1996) Quality of Outpatient Care Provided to Diabetic Patients: A Health Maintenance Organization Experience. Diabetes Care, 19, 601-606. http://dx.doi.org/10.2337/diacare.19.6.601|
|||Miller, K.L. and Hirsch, I.B. (1994) Physicians’ Practices in Screening for the Development of Diabetic Nephropathy and the Use of Glycosylated Hemoglobin Levels. Diabetes Care, 17, 1495-1497.
|||Chin, M.H., Auerbach, S.B., Cook, S., Harrison, J.F., Koppert, J., Jin, L., et al. (2000) Quality of Diabetes Care in Community Health Centers. American Journal of Public Health, 90, 431-434.
|||Chin, M.H., Zhang, J.X. and Merrell, K. (1998) Diabetes in the African-American Medicare Population: Morbidity, Quality of Care, and Resource Utilization. Diabetes Care, 21, 1090-1095.
|||Marshall, M.N., Shekelle, P.G., Leatherman, S.T. and Brook, R.H. (2000) The Public Release of Performance Data What Do We Gain? A Review of Evidence. Journal of the American Medical Association, 283, 1866-1874. http://dx.doi.org/10.1001/jama.283.14.1866|
|||Al-Malki, M., Fitzgerald, G. and Clark, M. (2011) Health Care System in Saudi Arabia: An Overview. Eastern Mediterranean Health Journal, 17, 784-793.|
|||Alzaid, A. (1997) Time to Declare War on Diabetes. Annals of Saudi Medicine, 17, 154-155.|
|||Fatani, H.H., Mira, S.A. and El-Zubier, A.G. (1987) Prevalence of Diabetes Mellitus in Rural Saudi Arabia. Diabetes Care, 10, 180-183. http://dx.doi.org/10.2337/diacare.10.2.180|
|||El-Hazmi, M., Warsy, A.S., Al-Swailem, A. and Sulaimani, R. (1998) Diabetes Mellitus as a Health Problem in Saudi Arabia. Eastern Mediterranean Health Journal, 4, 58-67.|
|||Gilles, C.L., Abrams, K.R., Lambert, P.C., Cooper, N.J., Sutton, A.J., Hsu, R.T., et al. (2007) Pharmacological and Lifestyle Interventions to Prevent or Delay Type 2 Diabetes in People with Impaired Glucose Tolerance: Systematic Review and Meta-Analysis. British Medical Journal, 334, 299-307.
|||Whiting, D.R., Guariguata, L., Weil, C., et al. (2011) IDF Diabetes Atlas: Global Estimates of the Prevalence of Diabetes for 2011 and 2030. Diabetes Research and Clinical Practice, 94, 311-321.|
|||Campbell, R., Pound, P., Pope, C., Brittenb, N., Pillc, R., Morgand, M., et al. (2003) Evaluating Meta-Ethnography: A Synthesis of Qualitative Research on Lay Experiences of Diabetes and Diabetes Care. Social Science & Medicine, 56, 671-684. http://dx.doi.org/10.1016/S0277-9536(02)00064-3|
|||Wu, C.J., Chang, A.M. and McDowell, J. (2008) Perspectives of Patients with Type 2 Diabetes Following a Critical Cardiac Event—An Interpretive Approach. Journal of Clinical Nursing, 17, 16-24.|
|||Khowaja, K. and Waheed, H. (2010) Self-Glucose Monitoring and Glycaemic Control at a Tertiary Care University Hospital Karachi, Pakistan. Journal of Pakistan Medical Association, 60, 1035-1038.|
|||Adams, C.R. (2003) Lessons Learned from Urban Latinas with Type 2 Diabetes Mellitus. Journal of Transcultural Nursing, 14, 255-265. http://dx.doi.org/10.1177/1043659603014003012|
|||Alcozer, F. (2000) Secondary Analysis of Perceptions and Meanings of Type 2 Diabetes among Mexican American Women. Diabetes Educator, 26, 785-795. http://dx.doi.org/10.1177/014572170002600507|
|||Ahmadani, M.Y., Haque, M.S., Basit, A., Fawwad, A. and Alvi, S.F.D. (2012) Ramadan Prospective Diabetes Study: The Role of Drug Dosage and Timing Alteration, Active Glucose Monitoring and Patient Education. Diabetic Medicine, 29, 709-715. http://dx.doi.org/10.1111/j.1464-5491.2011.03563.x|
|||Ahmadani, M.Y., Riaz, M., Fawaad, A., Hydrie, M.Z.I., Hakeem, R. and Basit, A. (2008) Glycaemic Trend during Ra- madan in Fasting Diabetic Subjects: A Study from Pakistan. Pakistan Journal of Biological Sciences, 11, 2044-2047. http://dx.doi.org/10.3923/pjbs.2008.2044.2047|
|||Broom, D. and Whittaker, A. (2004) Controlling Diabetes: Moral Language in the Management of Diabetes Type 2. Social Science & Medicine, 58, 2371-2382. http://dx.doi.org/10.1016/j.socscimed.2003.09.002|
|||Debussche, M. and Debussche, X. (2009) Hospitalization for Type 2 Diabetes: The Effects of the Suspension of Reality on Patients’ Subsequent Management of Their Condition. Qualitative Health Research, 19, 1100-1115.
|||Chasens, E.R. and Olshansky, E. (2006) The Experience of Being Sleepy While Managing Type 2 Diabetes. Journal of the American Psychiatric Nurses Association, 12, 272-278.
|||Chun, K.M. and Chesla, C.A. (2004) Cultural Issues in Disease Management for Chinese Americans with Type 2 Diabetes. Psychology and Health, 19, 767-785.
|||Chesla, C.A. and Chun, K.M. (2005) Accommodating Type 2 Diabetes in the Chinese American Family. Qualitative Health Research, 15, 240-255. http://dx.doi.org/10.1177/1049732304272050|
|||Fagerli, R.A., Lien, M.E. and Wandel, M. (2005) Experience of Dietary Advice among Pakistani-Born Persons with Type 2 Diabetes in Oslo. Appetite, 45, 295-304. http://dx.doi.org/10.1016/j.appet.2005.07.003|
|||Furler, J., Walker, C., Blackberry, I., Dunning, T., Sulaiman, N., Dunbar, J., et al. (2008) The Emotional Context of Self-Management in Chronic Illness: A Qualitative Study of the Role of Health Professional Support in the Self-Management of Type 2 Diabetes. BMC Health Services Research, 8, 214-222. http://dx.doi.org/10.1186/1472-6963-8-214|
|||Greenhalgh, T., Collard, A., Campbell-Richards, D., Vijayaraghavan, S., Malik, F., Morris, J., et al. (2011) Storyline of Self-Management: Narratives of People with Diabetes from a Multiethnic Inner City Population. Journal of Health Services Research & Policy, 16, 37-43. http://dx.doi.org/10.1258/jhsrp.2010.009160|
|||Hawthorne, K. and Tomlinson, S. (1999) Pakistani Moslems with Type 2 Diabetes Mellitus: Effect of Sex, Literacy Skills, Known Diabetic Complications and Place of Care on Diabetic Knowledge, Reported Self-Monitoring Management and Glycaemic Control. Diabetic Medicine, 16, 591-597.
|||Huang, E.S., Gorawara-Bhat, R. and Chin, M.H. (2005) Self-Reported Goals of Older Patients with Type 2 Diabetes Mellitus. Journal of the American Geriatrics Society, 53, 306-311.
|||Jezewski, M.A. and Poss, J. (2002) Mexican Americans’ Explanatory Model of Type 2 Diabetes. Western Journal of Nursing Research, 24, 840-858. http://dx.doi.org/10.1177/019394502237695|
|||Keval, H. (2009) Cultural Negotiations in Health and Illness: The Experience of Type 2 Diabetes among Gujarati-Speaking South Asians in England. Diversity in Health and Care, 6, 255-265.|
|||Koopman, R.J., Mainous, A.G. and Jeffcoat, A.S. (2004) Moving from Undiagnosed to Diagnosed Diabetes: The Patient’s Perspective. Family Medicine, 36, 727-732.|
|||Lawton, J., Ahmad, N., Hanna, L., Douglas, M. and Hallowell, N. (2006) “I Can’t Do Any Serious Exercise”: Barriers to Physical Activity Amongst People of Pakistani and Indian Origin with Type 2 Diabetes. Health Education Research, 21, 43-54. http://dx.doi.org/10.1093/her/cyh042|
|||Lawton, J., Parry, O., Peel, E., Araoza, G. and Douglas, M. (2005) Lay Perceptions of Type 2 Diabetes in Scotland: Bringing Health Services Back in. Social Science & Medicine, 60, 1423-1435.
|||Lawton, J., Parry, O., Peel. E. and Douglas, M. (2005) Diabetes Service Provision: A Qualitative Study of Newly Diagnosed Type 2 Diabetes Patients’ Experiences and Views. Diabetic Medicine, 22, 1246-1251. http://dx.doi.org/10.1111/j.1464-5491.2005.01619.x|
|||Lawton, J., Peel, E., Douglas, M. and Parry, O. (2004) “Urine Testing Is a Waste of Time”: Newly Diagnosed Type 2 Diabetes Patients’ Perceptions of Self-Monitoring. Diabetic Medicine, 21, 1045-1048.
|||Lawton, J., Peel, E., Parry, O. and Douglas, M. (2008) Shifting Accountability: A Longitudinal Qualitative Study of Diabetes Causation Accounts. Social Science and Medicine, 67, 47-56.
|||Macaden, L. and Clarke, C.L. (2006) Risk Perception among Older South Asian People in the UK with Type 2 Diabetes. International Journal of Older People Nursing, 1, 177-181.
|||Miller, D. and Brown, J.L. (2005) Marital Interactions in the Process of Dietary Change for Type 2 Diabetes. Journal of Nutrition Education and Behavior, 37, 226-234.
|||Moser, A., van der Bruggen, H., Spreeuwenberg, C. and Widdershoven, G. (2008) Autonomy through Identification: A Qualitative Study of the Process of Identification Used by People with Type 2 Diabetes. Journal of Nursing and Healthcare of Chronic Illness, in Association with Journal of Clinical Nursing, 17, 209-216.|
|||Nasmith, L., Coté, B., Cox, J., Inkell, D., Rubenstein, H., Jimenez, V., et al. (2004) The Challenge of Promoting Integration: Conceptualization, Implementation, and Assessment of a Pilot Care Delivery Model for Patients with Type 2 Diabetes. Family Medicine, 36, 40-45.|
|||Parry, O., Peel, E., Douglas, M. and Lawton, J. (2006) Issues of Cause and Control in Patient Accounts of Type 2 Diabetes. Health Education Research, 21, 97-107. http://dx.doi.org/10.1093/her/cyh044|
|||Peel, E., Parry, O., Douglas, M. and Lawton, J. (2005) Taking the Biscuit? A Discursive Approach to Managing Diet in Type 2 Diabetes. Journal of Health Psychology, 10, 779-791.
|||Polzer, R.L. and Miles, M.S. (2007) Spirituality in Africa Americans with Diabetes: Self-Management through a Relationship with God. Qualitative Health Research, 17, 176-188.
|||Poss, J.E., Jezewski, M. and Stuart, A.G. (2003) Home Remedies for Type 2 Diabetes Used by Mexican Americans in El Paso, Texas. Clinical Nursing Research, 12, 304-323.
|||Rayman, K.M. and Ellison, G.C. (2004) Home Alone: The Experience of Women with Type 2 Diabetes Who Are New to Intensive Control. Health Care for Women International, 25, 900-915.
|||Weiler, D.M. and Crist, J. (2009) Diabetes Self-Management in a Latino Social Environment. Diabetes Educator, 35, 285-292. http://dx.doi.org/10.1177/0145721708329545|
|||Wong, M., Gucciardi, E., Li, L. and Grace, S.L. (2005) Gender and Nutrition Management in Type 2 Diabetes. Canadian Journal of Dietetic Practice and Research, 66, 215-220.
|||Melia, K. (2010) Recognizing Quality in Qualitative Research. In: Bourgeault, I. and DeVries, R., Eds., Handbook of Qualitative Research, Sage, Thousand Oaks, 559-574.|
|||Sandelowskin, M. and Barroso, J. (2007) Handbook of Synthesizing Qualitative Research. Springer, New York, 312 p.|
|||Sandelowski, M. (2002) Finding the Findings in Qualitative Studies. Journal of Nursing Scholarship, 34, 213-219. http://dx.doi.org/10.1111/j.1547-5069.2002.00213.x|
|||Saini, M. and Shlonsky, A. (2012) Systematic Synthesis of Qualitative Research. Oxford University Press, New York, 224 p. http://dx.doi.org/10.1093/acprof:oso/9780195387216.001.0001|
|||Ali, M., Khalid, G.H. and Pirkani, G.S. (1998) Level of Health Education in Patients with Type 2 Diabetes Mellitus in Quetta. Journal of Pakistan Medical Association, 48, 334-336.|
|||Jabbar, A., Contractor, Z., Ebrahim, M.A. and Mahmood, K. (2001) Standard of Knowledge about Their Disease among Patients with Diabetes in Karachi, Pakistan. Journal of Pakistan Medical Association, 51, 6-8.|
|||Shera, A.S., Jawad, F. and Basit, A. (2002) Diabetes Related Knowledge, Attitude and Practices of Family Physicians in Pakistan. Journal of Pakistan Medical Association, 52, 465-470.|
|||Hasan, Z.U., Zia, S. and Maracy, M. (2000) Baseline Disease Knowledge Assessment in Patients with Type 2 Diabetes in a Rural Area of Northwest of Pakistan. Journal of Pakistan Medical Association, 54, 67-73.|
|||Adil, M.M., Alam, A.Y. and Jaffery, T. (2005) Knowledge of Type 2 Diabetes Patients about Their Illness: Pilot Project. Journal of Pakistan Medical Association, 55, 221-224.|
|||Sabri, A.A., Qayyum, M.A., Saigol, N.U., Zafar, K. and Aslam, F. (2007) Comparing Knowledge of Diabetes Mellitus among Rural and Urban Diabetics. McGill Journal of Medicine, 10, 87-89.|
|||Ulvi, O.S., Chaudhary, R.Y., Ali, T., Alvi, R.A., Khan, M.F., Khan, M., et al. (2009) Investigating the Awareness Level about Diabetes Mellitus and Associated Factors in Rural Islamabad. Journal of Pakistan Medical Association, 59, 798-780.|
|||Afridi, M.A. and Khan, M.N (2003) Role of Health Education in the Management of Diabetes Mellitus. Journal of College of Physicians and Surgeons Pakistan, 13, 558-561.|
|||Pendleton, D., Schofield, T. and Tate, P. (1984) The Consultation: An Approach to Learning and Teaching. Oxford University Press, Oxford.|
|||Feudtner, C. (2003) Bittersweet: Diabetes, Insulin and Transformation of Illness. University of North Caroline Press, Chapel Hill.|
|||Whittemore, R., Chase, S., Mandle, C.L. and Roy, S.C. (2001) The Content, Integrity, and Efficacy of a Nurse Coaching Intervention in Type 2 Diabetes. Diabetes Educator, 27, 887-898.
|||Mol, A. (2008) The Logic of Care: Health and the Problem of Patient Choice. Routledge, Milton Park.|
|||Dixon-Woods, M., Booth, A. and Sutton, A.J. (2007) Synthesizing Qualitative Research: A Review of Published Reports. Qualitative Research, 7, 375-422. http://dx.doi.org/10.1177/1468794107078517 eww150209lx|