6 - The management of diabetes among the rural poor in South Africa
Corresponding Author(s) : Olajide Oloyede
African Sociological Review,
Vol. 17 No. 2 (2013): African Sociological Review
Abstract
The objective of this study was to examine the management of diabetes mellitus Type 2 among the rural poor in South Africa. The focus group method was used. Data was elicited from 20 group sessions over a 20-week period on health beliefs and attitudes and rural-dwelling diabetes sufferers’ strategies for managing the condition. The study shows poor knowledge of diabetes and poor self-management as delineated in the medical literature. The focus of the rural dwellers’ self-management of diabetes was hypoglycaemic control through regular consumption of very-high-calorie food, the type of which have been found to lead to a diet that has very high carbohydrate, high in saturated fatty acids, excess salt and unrefined sugar. The rationale for this is the misconception that hypoglycaemia is a product of low food intake, which would seem to suggest their perception of illness and health belief than the understanding of chronic illness. It was concluded that the government and health care professionals have to do more to develop interventions to facilitate good self-management of diabetes among the rural people. Such interventions should address the sufferers’ knowledge of diabetes.
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- American Diabetes Association. The pharmacological treatment of hyperglycaemia in NIDDM. Diabetes Care. 18:1510-1518
- Barburr, R. and Kitzinger J. (eds.) (1998) Developing Focus groups research. London: Sage Bruce, David, G., Davis, Wendy, A., Cull, Caroline, A. and Davis, Timothy, M. E. (2003) Diabetes Education and Knowledge in patients with type 2 diabetes from the community The Freemantle Diabetes Study. Journal of Diabetes and its Complications. 17:82-89
- Bruckert, E., Simonetta, C., and Giral, P. (1999) Compliance with Florastatin treatment characterization of the noncompliant population with a population of 3854 patients with hyperlipidemi: CREOLE study team. Journal of Clinical Epidemiology. 52:589-594
- Carver, Charles, S., Scheier, Michael. F. and Weintraub, Jagdish, Kumani (1986) Assessing Coping Strategies: A Theoretically Based Approach. Journal of Personality and Social Disorder. Vol. 56, 2:267-283
- Charmarz, K. (1990) Discovering chronic illness: Using grounded theory. Social Science and Medicine. 30:1161-1172
- Fife, B. L. (1995) The measurement of meaning in illness. Social Science and Medicine.40 (8): 1021-1028
- Folkman, S. and Lazarus, R.S. (1980) An analysis of coping in a middle-aged community sample. Journal of Health and Social Behaviour. 2:219-239
- Folkman, S., Lazarus, R.S., Dunkel-Schetter, C., DeLongis, A. and Gruen, R.J. (1986) Dynamics of stressful encounter: Cognitive appraisal, coping and encounter extremes. Journal of Personality and Social Psychology. 50:992-1003
- Gonen, B., Rubeistein, A.H., Rochman, H., Tanegam, S. P. and Hirwitz, D. L (1977) Haemoglobin A1: An indicator of the metabolic control of diabetes patients. Lancet 2:737- 736
- Harris, M. A., Wysocki, T., Sadler, M., Wilkinson, K., Harvey, L. M., Bruckloh, L. M., Marras, N. and White, N. H. (2000) Validation of a structured interview for the assessment of diabetes self-management. Diabetes Care. 23:1301-1304
- Hirschowitz, R. (2000) Measuring Poverty. Pretoria: Statistics South Africa
- Hoppe, M., Nell, E. A., Wilsdon, A., Gilman, M. R. and Morrison, D. M. (1994) Children’s Knowledge and beliefs about AIDS: Qualitative Data from focus group interviews. Health Education Quarterly. 21:117-126
- Kaplan. R. M., Sallis, J. F. and Patterson, T. L. (1993) Health and Human Behaviour.New York: McGraw Hill
- Kitzinger, J. (1995) Introducing Focus Groups. British Medical Journal 12(3): 319-335;
- Krueger, R. A. (1994) Focus groups: A practical guide for applied research (2nd.Edn.), Newbury Park; CA: Sage
- Lazarus, R. S. and Folkman, S (1984) Stress appraisal and coping. New York: Springer Mason, J. (1987) Qualitative Researching. London: Sage
- Morgan, D. R. (1996) Focus groups. Annual Review of Sociology. 22:129-152 Morgan, D. L. and Krueger, R. A. (1993) When to use focus groups and why, pp.3-19: In: Successful focus groups: Advancing the state of the art Morgan, D. L. (ed.) London: Sage
- Norris, S. L., Engelgao, M. M., Narayan, K. M. (2001) Effectiveness of self- management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 24:561-587
- Oloyede, O. (2004) A survey of diabetes mellitus in selected health centres in the Eastern Cape. Unpublished Report. Alice: University of Fort Hare.
- Radley, A (1999) Social Realms and the qualities of illness experience, pp.16-30: In: Qualitative health psychology: Theories and Methods. M. Murray and K. Chamberlain (Eds.). London: Sage
- Rand,C.S (1993) Measuring adherence with therapy for chronic diseases: Implications for the treatment of heterozygous familial hypercholesterolemia. American Journal of Cardiology. 72:68D-74D
- Scheier, M.F., Weintraub, J. K and Carver, C. S. (1986) Coping with stress: Divergent strategies of optimists and pessimists. Journal of Personality and Social Psychology. 51:1257- 1264
- Schrott, H. G., Bittner, V., Vittinghloff, E., Herrington, D. M. and Hulley, S, (1997) Adherence to National Cholestorol Education Programme treatment goals in postmenopausal women with heart disease. Journal of the American Medical Association. 277:1281-1286
- Snehalatha, C., Ramachandran, A., Satyavani, K. and Vijay, V (2000) Limitations of glucosylated haemoglobin as an indicator of glucose intolerance. Diabetes Research and Clinical Practice. 47:129-133.
- Stewart, D. W. and Shamdasani, P. N (1990) Focus groups: Theory and Practice.London: Sage
- Toobert, D. J., Hampson, S. E. and Glasgow, R. E. (2000) The summary of diabetes self-care activities and a revised scale. Diabetes Care. 23:943-950
- United Kingdom Prospective Diabetes Study (UKPDS) Group. (1998) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34).
- Lancet. 352:854- 865 (Erratum (1998), pp. 1557: In: Lancet 352).
- Ware, N. C and Kleinman, A (1992) Culture and Somatic experience: The social course of illness in neurasthenia and chronic fatigue syndrome. Psychosomatic Medicine 54:546-560
References
American Diabetes Association. The pharmacological treatment of hyperglycaemia in NIDDM. Diabetes Care. 18:1510-1518
Barburr, R. and Kitzinger J. (eds.) (1998) Developing Focus groups research. London: Sage Bruce, David, G., Davis, Wendy, A., Cull, Caroline, A. and Davis, Timothy, M. E. (2003) Diabetes Education and Knowledge in patients with type 2 diabetes from the community The Freemantle Diabetes Study. Journal of Diabetes and its Complications. 17:82-89
Bruckert, E., Simonetta, C., and Giral, P. (1999) Compliance with Florastatin treatment characterization of the noncompliant population with a population of 3854 patients with hyperlipidemi: CREOLE study team. Journal of Clinical Epidemiology. 52:589-594
Carver, Charles, S., Scheier, Michael. F. and Weintraub, Jagdish, Kumani (1986) Assessing Coping Strategies: A Theoretically Based Approach. Journal of Personality and Social Disorder. Vol. 56, 2:267-283
Charmarz, K. (1990) Discovering chronic illness: Using grounded theory. Social Science and Medicine. 30:1161-1172
Fife, B. L. (1995) The measurement of meaning in illness. Social Science and Medicine.40 (8): 1021-1028
Folkman, S. and Lazarus, R.S. (1980) An analysis of coping in a middle-aged community sample. Journal of Health and Social Behaviour. 2:219-239
Folkman, S., Lazarus, R.S., Dunkel-Schetter, C., DeLongis, A. and Gruen, R.J. (1986) Dynamics of stressful encounter: Cognitive appraisal, coping and encounter extremes. Journal of Personality and Social Psychology. 50:992-1003
Gonen, B., Rubeistein, A.H., Rochman, H., Tanegam, S. P. and Hirwitz, D. L (1977) Haemoglobin A1: An indicator of the metabolic control of diabetes patients. Lancet 2:737- 736
Harris, M. A., Wysocki, T., Sadler, M., Wilkinson, K., Harvey, L. M., Bruckloh, L. M., Marras, N. and White, N. H. (2000) Validation of a structured interview for the assessment of diabetes self-management. Diabetes Care. 23:1301-1304
Hirschowitz, R. (2000) Measuring Poverty. Pretoria: Statistics South Africa
Hoppe, M., Nell, E. A., Wilsdon, A., Gilman, M. R. and Morrison, D. M. (1994) Children’s Knowledge and beliefs about AIDS: Qualitative Data from focus group interviews. Health Education Quarterly. 21:117-126
Kaplan. R. M., Sallis, J. F. and Patterson, T. L. (1993) Health and Human Behaviour.New York: McGraw Hill
Kitzinger, J. (1995) Introducing Focus Groups. British Medical Journal 12(3): 319-335;
Krueger, R. A. (1994) Focus groups: A practical guide for applied research (2nd.Edn.), Newbury Park; CA: Sage
Lazarus, R. S. and Folkman, S (1984) Stress appraisal and coping. New York: Springer Mason, J. (1987) Qualitative Researching. London: Sage
Morgan, D. R. (1996) Focus groups. Annual Review of Sociology. 22:129-152 Morgan, D. L. and Krueger, R. A. (1993) When to use focus groups and why, pp.3-19: In: Successful focus groups: Advancing the state of the art Morgan, D. L. (ed.) London: Sage
Norris, S. L., Engelgao, M. M., Narayan, K. M. (2001) Effectiveness of self- management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 24:561-587
Oloyede, O. (2004) A survey of diabetes mellitus in selected health centres in the Eastern Cape. Unpublished Report. Alice: University of Fort Hare.
Radley, A (1999) Social Realms and the qualities of illness experience, pp.16-30: In: Qualitative health psychology: Theories and Methods. M. Murray and K. Chamberlain (Eds.). London: Sage
Rand,C.S (1993) Measuring adherence with therapy for chronic diseases: Implications for the treatment of heterozygous familial hypercholesterolemia. American Journal of Cardiology. 72:68D-74D
Scheier, M.F., Weintraub, J. K and Carver, C. S. (1986) Coping with stress: Divergent strategies of optimists and pessimists. Journal of Personality and Social Psychology. 51:1257- 1264
Schrott, H. G., Bittner, V., Vittinghloff, E., Herrington, D. M. and Hulley, S, (1997) Adherence to National Cholestorol Education Programme treatment goals in postmenopausal women with heart disease. Journal of the American Medical Association. 277:1281-1286
Snehalatha, C., Ramachandran, A., Satyavani, K. and Vijay, V (2000) Limitations of glucosylated haemoglobin as an indicator of glucose intolerance. Diabetes Research and Clinical Practice. 47:129-133.
Stewart, D. W. and Shamdasani, P. N (1990) Focus groups: Theory and Practice.London: Sage
Toobert, D. J., Hampson, S. E. and Glasgow, R. E. (2000) The summary of diabetes self-care activities and a revised scale. Diabetes Care. 23:943-950
United Kingdom Prospective Diabetes Study (UKPDS) Group. (1998) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34).
Lancet. 352:854- 865 (Erratum (1998), pp. 1557: In: Lancet 352).
Ware, N. C and Kleinman, A (1992) Culture and Somatic experience: The social course of illness in neurasthenia and chronic fatigue syndrome. Psychosomatic Medicine 54:546-560