UCLA

Aim: To understand the barriers Latino Adolescents have to self-manage their diabetes. Type 2 diabetes mellitus (T2DM) is a growing problem among Latino adolescents. An even bigger problem is the lack of adherence to self-management of the disease within this population, but little is known about what adolescents perceive as barriers to diabetes self-management.

Methods: This study utilized grounded theory in a qualitative design to explore and understand the barriers to effective diabetes self-management care from the perspective of Latino adolescents with T2DM. Focus groups were conducted with 12 participants to identify the important topics for the individual interviews. Other 15 adolescents participated in the in depth individual interviews. All focus groups and individual interviews were video-taped and coding was done directly from the videos. All participants were recruited from Children’s Hospital Los Angeles.

Results: Participants were 44.4% female, mean age was 16.3 years (SD 2.1), and 92.6% had a BMI >85% for age. They had T2DM for a mean of 3.86 years (SD 2.1), and they had poor metabolic control with a mean HbA1c of 9.1% (SD2.2%). Qualitative data revealed that the intrapersonal barriers and facilitators were the most important factors that influenced the participants in making decisions about their diabetes self-management. The core category was identified as “Acceptance of diabetes”. This study revealed that when Latino adolescents accepted that they have diabetes, and that it is not going away, they were able to embrace it and were able to overcome all the negative influences and perform diabetes self-management tasks. In order to achieve acceptance participants need to have a combination of a positive outlook in life, high self-esteem, be independent and resilient, and need to have some social support.

Conclusions: This study has generated new knowledge that may have very important implications in the treatment of Latino adolescents with T2DM. Medical providers working with this population need to understand their barriers to treatment and need to implement changes in practice to help these youths acquire the necessary skills and qualities to achieve Acceptance of their diabetes.