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Experiences of First Nations adolescents living with type 2 diabetes: a focus group study

Brandy Wicklow¹, Allison Dart², Jackie McKee²

¹Department of Pediatrics and Child Health (Wicklow, Dart), University of Manitoba; Children's Hospital Research Institute of Manitoba (Wicklow, Dart), Winnipeg, Man.; Waywayseecappo First Nation (McKee), Waywayseecappo, Man.; Brandon University (Griffiths), Brandon, Man.; Department of Clinical Health Psychology (Malik), University of Manitoba, Winnipeg, Man.; Wabaseemoong First Nation (Quoquat), Whitedog, Ont.; Department of Community Health Sciences (Bruce), University of Manitoba, Winnipeg, Man. bwicklow@hsc.mb.ca.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne

|March 23, 2021

Abstract

Background:

Despite prevention efforts, type 2 diabetes mellitus continues to increase in incidence among First Nations children and is associated with early and aggressive complications. We aimed to determine the experiences of adolescents living with type 2 diabetes and the barriers to living well with type 2 diabetes that adolescents perceived.

Methods:

We recruited adolescents with type 2 diabetes mellitus from the pediatric diabetes clinic in Winnipeg, Manitoba, to participate in a day-long facilitated focus group discussion. Group discussions were recorded and transcribed verbatim. We used interpretive description methodology to inform the thematic analysis of the transcripts.

Results:

Eight adolescents with a mean age of 15 years participated. Five adolescents identified as female; most were Indigenous (7/8). The mean duration since diagnosis of diabetes was 2.5 years. Adolescents reported struggling with acceptance of their diagnosis, with the stigma and shame associated with the diagnosis and with daily self-management tasks. Three themes were developed from the focus group discussions: bearing witness, the "weight" of diabetes and support (lack of support).

Interpretation:

Adolescents with diagnoses of type 2 diabetes experience associated stigma and shame, which are substantial barriers to self-care. A broader understanding of their lived experience, including the socioecological and emotional context, could help to improve health care provision and intervention strategies for this population.

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