An Exploration of Nutrition Information Practice in People with Type 2 Diabetes Mellitus

Abstract

People with type 2 diabetes mellitus (T2DM) need information about what to eat in order to be able to self-manage their diabetes and to prevent long term complications. Their information activities involve accessing information from a wide range of sources. While studies have explored nutrition information activities, few have identified the instinctive, embodied and hidden nature of everyday information practice. This study aims to investigate the nutrition information practices undertaken by people with T2DM, to identify information accessed and used, and its perceived value.

The study consisted of a systematic review which informed an empirical research study. The systematic review utilised a narrative approach to the analysis of the 28 included studies. The empirical research study involved 20 people, 19 with T2DM (and one partner without T2DM) who were recruited through diabetes support groups and the researcher’s workplace. Practice theory underpinned a social constructionist qualitative methodological approach. The diary-interview method involved participants completing diaries to capture their nutrition information experiences followed by an in-depth interview, to further explore these experiences. Data were analysed using thematic analysis.

The systematic review identified that nutrition information practices were key to the self-management of people with T2DM. The complexity of nutrition information and the tacit nature of information practice made this worthy of further research. The empirical study identified that experiences of diagnosis affected the way that T2DM was integrated into everyday lives and impacted on participants’ T2DM self-management. Participants developed personal embodied ‘rules of thumb’ towards the way they managed their diabetes and expressed feelings of guilt if they strayed from these. Beliefs, embodied knowledge and skills affected engagement with information sources such as food labels and peer support groups. Information practices were influenced by the degree to which diabetes was embodied and were interconnected with food-related practices.

The study highlighted that some information, for example designed to assist in self-management and making food provisioning decisions, is challenging for people with T2DM to use. Sharing of information with peers in a support group setting could be of value to people with T2DM. People living with T2DM need ongoing support and encouragement in developing information practices that assist with their self-management.

Patient-led dietetic consultations could be enhanced through the use of nutrition information diaries to help identify and develop embodied nutrition information practices. Peer support groups could be recommended to help people who are newly diagnosed to come to terms with diabetes and to encourage diabetes self-management. The content and format of food labels is in need of review to enable interpretation by those with T2DM and to support the choice of foods with inherent nutritional value. This study challenges the current body of research relating to information activity and proposes information practice as a theoretical framework that could be used by practitioners and academics to explore information activities further.