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Cited by 195Diabetes Management and EducationMedication Adherence and ComplianceDiabetes, Cardiovascular Risks, and Lipoproteins

Barriers to following dietary recommendations in type 2 diabetes

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Vijan, S., Stuart, N. S., Fitzgerald, J. T., Ronis, D. L., Hayward, R. A., Slater, S., Hofer, T. P.·2005·Diabetic Medicine
DOI 10.1111/j.1464-5491.2004.01342.x
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Abstract

Aims To evaluate barriers to following dietary recommendations in patients with Type 2 diabetes. Methods We conducted focus groups and surveys in urban and suburban VA and academic medical centres. For the written survey, a self‐administered questionnaire was mailed to a random sample of 446 patients with diabetes. For the focus groups, six groups of patients with diabetes (three urban, three suburban) were conducted, with 6–12 participants in each group. The focus groups explored barriers across various types of diabetes self‐management; we extracted all comments relevant to barriers that limited patients’ ability to follow a recommended diet. Results The written survey measured the burden of diabetes therapies (on a seven‐point rating scale). Moderate diet was seen as a greater burden than oral agents (median 1 vs. 0, P = 0.001), but less of a burden than insulin (median 1 vs. 4, P < 0.001). A strict diet aimed at weight loss was rated as being similarly burdensome to insulin (median 4 vs. 4, P = NS). Despite this, self‐reported adherence was much higher for both pills and insulin than it was for a moderate diet. In the focus groups, the most commonly identified barrier was the cost (14/14 reviews), followed by small portion sizes (13/14 reviews), support and family issues (13/14 reviews), and quality of life and lifestyle issues (12/14 reviews). Patients in the urban site, who were predominantly African‐American, noted greater difficulties communicating with their provider about diet and social circumstances, and also that the rigid schedule of a diabetes diet was problematic. Conclusions Barriers to adherence to dietary therapies are numerous, but some, such as cost, and in the urban setting, communication with providers, are potentially remediable. Interventions aimed at improving patients’ ability to modify their diet need to specifically address these areas. Furthermore, treatment guidelines need to consider patients’ preferences and barriers when setting goals for treatment.

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  • Many studies have reported that individuals with type 2 diabetes suffer from disease-related barriers to exercise adoption and diet modulation.

    “Further, many studies have reported that individuals withT2D suffer from disease‐related barriers to exercise adoption and diet modulation (Vijan 2005; Wahl 2018).”

    From Mindfulness-based interventions for adults with type 2 diabetes mellitus (2021) · cites this paper as Vijan 2005

    The Abstract and Focus groups sections report barriers that patients with type 2 diabetes faced in following dietary recommendations, including cost, portion size, and family support. The Introduction says this study focuses on prescribed diets; it mentions benefits of exercise but does not report barriers to adopting it. Thus Vijan supports the diet portion of the sentence, not the exercise portion. (LLM, conf=0.88)

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Cited by

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Authors
Vijan, S., Stuart, N. S., Fitzgerald, J. T., Ronis, D. L., Hayward, R. A., Slater, S., & Hofer, T. P.
Affiliations
University of Michigan (US)
Corresponding author
Vijan, S.
ORCID
Venue
Diabetic Medicine
Publisher
Wiley
Published
2004-12-02
Volume
22
Issue
1
Pages
32-38
ISSN
  • 0742-3071 (ISSN-L)
  • 1464-5491
DOI
10.1111/j.1464-5491.2004.01342.x
OpenAlex
W2153626252
Cited by
195
References
1
Citations by year
2026: 2 · 2025: 3 · 2024: 9 · 2023: 8 · 2022: 8 · 2021: 9 · 2020: 12 · 2019: 6 · 2018: 11 · 2017: 10 · 2016: 12 · 2015: 12 · 2014: 17 · 2013: 16 · 2012: 10
FWCI
2.75
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Diabetic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
U.S. Department of Veterans Affairs
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
type 2 diabetes, dietary recommendations, dietary adherence, diabetes self-management, portion size, family support, quality of life, provider communication, African American patients, insulin, oral antidiabetic drugs, weight loss diet
MeSH terms
Diabetes Mellitus, Type 2, Female, Health Surveys, Humans, Male, Middle Aged, Patient Compliance, Self Care, Urban Health, Focus Groups, Suburban Health

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