Beyond compliance: Lived experiences of type 2 diabetes self-management in Wales

Good self-management is widely regarded as being essential for preventing complications and improving quality of life for individuals with type 2 diabetes (T2D). The healthcare system in Wales continues to rely heavily on compliance-driven models of care, which are often at odds with patient experience. This study explores the lived experiences of adults with T2D living in Wales, which has the highest prevalence of diabetes in the United Kingdom, focusing on how individuals understand their condition and navigate the lifelong challenges of daily self-care.

A qualitative study using interpretative phenomenological analysis (IPA) to capture in-depth insights into individual experiences of T2D self-management.

Ten in-depth semi-structured interviews were conducted with adults living in Wales who had been diagnosed with T2D for at least 6 months. Interviews explored participants' perceptions of their condition and their self-care practices within the context of their everyday lives.

Four interrelated themes emerged: perceptions of diabetes, practices of self-care, barriers to sustained engagement and the emotional and practical work of maintaining behaviours. Participants described self-management as a fluctuating, emotionally charged process shaped by personal motivation, social relationships, cultural expectations and structural constraints, including limited access to education, fragmented care and rural isolation.

There is a clear need for more person-centred, relational and contextually sensitive models of care in Wales. Supporting individuals with T2D requires more than providing information and instruction; it demands empathy, continuity and services that respond to the lived complexity of managing this long-term condition.