Uncertainty and certainty: perceptions and experiences of prediabetes in New Zealand primary care – a qualitative study
Eileen McKinlay
1 * , Jo Hilder 1 , Fiona Hood 2 , Sonya Morgan 1 , Christine Barthow 2 , Ben Gray 1 , Mark Huthwaite 3 , Mark Weatherall 2 , Julian Crane 2 , Jeremy Krebs 2 , Sue Pullon 1
+ Author Affiliations
- Author Affiliations
1 Department of Primary Health Care and General Practice, University of Otago, Wellington, Newtown, Wellington 6021, New Zealand.
2 Department of Medicine, University of Otago, Wellington, Newtown, Wellington 6021, New Zealand.
3 Department of Psychological Medicine, University of Otago, Wellington, Newtown, Wellington 6021, New Zealand.
Journal of Primary Health Care 14(2) 138-145 https://doi.org/10.1071/HC21066
Published: 8 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Introduction: Prediabetes is the asymptomatic precursor to type two diabetes mellitus, a significant and growing public health problem in New Zealand (NZ). Little is known about how general practitioners (GPs) and nurses view prediabetes care, and similarly little is known about how people with prediabetes view their condition and care.
Aim: This study aimed to investigate the views of NZ GPs and nurses, and people with prediabetes about prediabetes and its management.
Methods: This was a mixed qualitative methods study that is part of a randomised control trial of a prediabetes intervention.
Results: Three key themes emerged from the health professional data (GPs and nurses) and another three themes emerged from people with prediabetes data. GPs and nurses were uncertain about the progression of prediabetes; they felt prediabetes was not a priority and they were unsure about what to advise. People with prediabetes were uncertain about the diagnosis and information given to them; they were unsure about what to do about prediabetes and they found lifestyle change hard.
Discussion: GPs, nurses and people with prediabetes, expressed much uncertainty, but also some certainty about prediabetes. All were certain that prediabetes is common and increasing and that sustained lifestyle change was very difficult. But uncertainty prevailed about whether, in reality, prediabetes could be stopped, who would be most likely to benefit from lifestyle interventions and how best to achieve these. Older Māori and Pacific women were keen to promote lifestyle change and this appeared best done through Māori and Pacific peoples’ organisations by means of co-designed interventions.
Keywords: exercise, lifestyle factors, nutrition, prediabetes, prevention, primary care, public health, type 2 diabetes mellitus.
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