CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / O nÃo cumprimento do regime medicamentoso, por parte dos usuÃrios com Diabetes Mellitus tipo 2 (DM 2), à um dos principais problemas encontrados para a manuntenÃÃo do equilÃbrio glicÃmico e, consenquentemente, prevenÃÃo das complicaÃÃes micro e macrovasculares do DM 2. O estÃgio desse problema e a melhor forma para detectÃ-lo ainda nÃo estÃo definidos em Fortaleza-CE e em outras partes do paÃs. Dessa maneira, objetivou-se avaliar o cumprimento da terapia farmacolÃgica de usuÃrios com DM 2 aos antidiabÃticos oriais na rede bÃsica de Fortaleza-CE e validar dois mÃtodos indiretos utilizados para medir o cumprimento do tratamento medicamentosos: o teste de Batalla e o teste adaptado de Morisky, Green e Levine e Delgado e Lima (MGLDL). Trata-se de um estudo tranversal e de uma validaÃÃo de critÃrio. Foram investigados 437 usuÃrios com DM 2, de ambos os sexo, na faixa etÃria de 18-92 anos de idade, de 12 Unidades BÃsicas de SaÃde da FamÃlia (UBASF), duas unidades de cada uma das seis regiÃes do municÃpio, durante os meses de marÃo a junho de 2009. Nas UBASF foi utilizado um formulÃrio para coleta das informaÃÃes sociodemogrÃficas, clÃnicas e medicamentosas. AlÃm disso, foi entregue a cada pesquisado uma embalagem plÃstica para armazenagem dos antidiabÃticos orais prescritos. No domicÃlio dos sujeitos foram aplicados o Teste de Batalla, o MLGDL e a contagem dos comprimidos armazenados na embalagem plÃstica disponibilizada. Na determinaÃÃo do cumprimento do tratamento farmacolÃgico a contagem de comprimidos foi considerado o mÃtodo padrÃo ouro. Os dados sofreram tripla digitaÃÃo e foram armazenados no software SPSS. Na anÃlise dos dados foram calculados estatÃstica descritiva, coficientes de validaÃÃo, correlaÃÃo de Spearman e o Alpha de Cronbach. Houve uma maior participaÃÃo feminina (70,3%), daqueles com idade entre 18-59 anos (41,1%) e dos casados (55,8%). A classe econÃmica e escolaridade predominates foram a D (47,8%) e o primÃrio incompleto (38,9%). A prevalÃncia de nÃo cumprimento ao tratamento com antidiabÃticos orais foi de 74,6; 86,3 e 71,2, segundo os mÃtodos de Batalla, MGLDL e contagem de comprimidos, respectivamente. Em relaÃÃo ao padrÃo ouro, o teste MGLDL (66,3%) apresentou uma associaÃÃo maior de casos de nÃo cumprimento ao regime medicamentoso do que Batalla (p=0,000). Todos os coeficientes de validade do mÃtodo de MGLDL foram maiores que o de Batalla. O teste MGLDL apresentou uma melhor correlaÃÃo com a contagem de comprimidos (p<0,001) e exatidÃo do que o de Batalla (0,646>0,561). Portanto, o teste MGLDL demonstrou ser mais qualificado na detecÃÃo de usuÃrios com DM 2 nÃo cumpridores da terapÃutica medicamentosa a partir de antidiabÃticos orais. à pertinente que o enfermeiro da atenÃÃo bÃsica possa conhecer esse mÃtodo, a fim de identificar usuÃrios com DM 2 nÃo cumpridores e orientÃ-los na perspectiva de melhorar sua adesÃo à terapÃutica medicamentosa.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A nÃo adesÃo do paciente portador de Diabetes Mellitus tipo 2 (DM 2) ao tratamento medicamentoso com antidiabÃticos orais vem sendo observada pelos profissionais de saÃde, constituindo-se em um dos principais problemas para a manutenÃÃo do equilÃbrio glicÃmico. AlÃm disso, sÃo muitos os fatores que podem influenciar na nÃo adesÃo do portador de DM 2 aos antidiabÃticos orais e, nÃo hà consenso acerca de quais deles tÃm maior influÃncia. Objetivou-se, com este estudo, conhecer os fatores que interferem na nÃo adesÃo do portador de DM 2 à terapÃutica medicamentosa com antidiabÃticos orais. Trata-se de um estudo nÃo-experimental, descritivo e transversal realizado com 377 pacientes nÃo aderentes ao tratamento medicamentoso, de ambos os sexos, com idade entre 18 e 92 anos. A pesquisa foi realizada durante os meses de marÃo a julho de 2009, em 12 Centros de SaÃde da FamÃlia- CSF da cidade de Fortaleza-CE, sendo escolhidas, por conveniÃncia, duas unidades de cada uma das seis regiÃes. Nos CSF foi utilizado um formulÃrio para a coleta das informaÃÃes sociodemogrÃficas, clÃnicas e medicamentosas. Os dados sofreram tripla digitaÃÃo e foram armazenados no software SPSS. A fim de se verificar a existÃncia de associaÃÃes entre as variÃveis dependentes e causais, foram feitas tabelas cruzadas e aplicaram-se os testes de &#61539;2 e o de Fisher. Para todos os testes, foi fixado o nÃvel de significÃncia de 5%. Como resultados, verificou-se que 69,5% eram do sexo feminino, 30,5% estavam na faixa etÃria de 60-69 anos, 47,7% eram brancos, 57,0% mantinham uma uniÃo consensual ou eram casados, 48,0% eram aposentados, 48,3% estavam inseridos na classe econÃmica D, 37,7% possuÃam apenas o fundamental incompleto e, 69,0% eram catÃlicos. Ao serem feitas as associaÃÃes entre a nÃo adesÃo e os fatores sociodemogrÃficos, prevaleceram os sujeitos do sexo masculino (88,5%), os de menor idade (89,8%), os com a cor de pele amarela (90,9%), os que possuÃam ensino mÃdio completo (94,1%), os casados (87,4%) e os de melhor classe econÃmica (92,9%). Em nenhum desses cruzamentos foi verificado uma associaÃÃo estatisticamente significante (p=0,386, p=0,181, p=0,635, p=0,786, p=0,846 e p=0,626), respectivamente. Os indivÃduos que possuÃam algum emprego (formal e informal) ou que eram autÃnomos, foram os pacientes que apresentaram maiores Ãndices de nÃo adesÃo aos antidiabÃticos orais (p=0,048).Quanto aos fatores clÃnicos, a nÃo adesÃo esteve associada, estatisticamente, ao nÃo comparecimento Ãs consultas (p=0,000), ao uso de outros fÃrmacos alÃm dos antidiabÃticos orais (p=0,039), ao etilismo (p=0,005) e à alteraÃÃo da glicemia (p=0,013). NÃo houve uma associaÃÃo estatisticamente significante entre a nÃo adesÃo e o recebimento de orientaÃÃes sobre como tomar os medicamentos (p=0,325), assim como o entendimento das informaÃÃes repassadas (p=0,426) e o recebimento de algum material explicativo sobre DM 2 (p=0,081). Outros estudos devem ser desenvolvidos para que novas populaÃÃes possam ser pesquisadas, novos fatores identificados e novas associaÃÃes encontradas. AlÃm disso, podem ser planejadas investigaÃÃes com o objetivo de avaliar medidas de intervenÃÃo, como estratÃgias de educaÃÃo em saÃde. / Non-compliance to drug therapy in patients with Diabetes Mellitus type 2 (DM 2) has been observed by health professionals as a major problem for the mantaining the glucose balance. In addition, there are many factors that can influence the non-compliance of patients with DM 2 to oral drugs, and there is no consensus about which ones have the most influence. This study aims to determine the factors that affect the non-compliance to drug therapy with oral antidiabetics in patients with DM 2. This is a non-experimental study, with descriptive and cross-sectional aproach, performed with 377 patients non-adherents to drug treatment, both sexes, aged between 18 and 92 years. The research was conducted during the months from March to July 2009, in 12 Family Health Centers (CSF) of Fortaleza â CE. Two units of each of the six regions have being chosen, for convenience. A formulary was used for the collection of sociodemographic, clinical and therapy information. The data were triple typing and stored in the software SPSS. In order to verify the existence of associations between dependent and causal variables, we made crossed tables and we applied the Qui-square test and Fisher test. A significance level of 5% was set for all tests. As a result, it was found that 69.5% of the sample were female, 30.5% were located in the age group of 60-69 years, 47.7% were white, 57.0% had a consensual union or were married, 48.0% were retired, 48.3% were part of the socioeconomic class D, 37.7% had, as schooling, the incomplete primary and 69.0% were catholics. By making associations between non-compliance and sociodemographic variables, prevailed male subjects (88.5%), those of younger age (89.8%), those with yellow skin (90.9%), those who had high school (94.1%), couples (87.4%) and those with a better socioeconomic status (92.9%). It wasnÂt found statistical significant associations in none of these crossings (p = 0.386, p = 0.181, p = 0.635, p = 0.786, p = 0.846 and p = 0.626, respectively). Individuals who have some employment (formal and informal) or who were self-employed, were the patients who had higher non-compliance to oral hypoglycemic agents (p = 0.048). Regarding the clinical factors, non-compliance was statistically associated with absence in consultations (p = 0.000), use of other drugs in addition to oral hypoglycemic agents (p = 0.039), use of alcohol (p = 0.005) and changes in blood glucose levels (p = 0.013). It wasnÂt found statistical association between non-compliance and the receiving of recommendations about how to take the medications (p = 0.325), as well as the understanding of the given information (p = 0.426) and the receipt of any explanatory material about DM 2 (p = 0.081). Other studies should be developed so that new populations can be investigated, new factors can be indentified and new associations can be found. Moreover, investigations with the aim of evaluate interventions, as health education strategies, can be planned.

Diabetes mellitus är en av de vanligaste endokrina sjukdomarna och de vanligaste formerna är typ I och typ II. Idag har ca 350 000 personer i Sverige diabetes och av dessa har 85-90% diabetes typ II. Typ II diabetes börjar med insulinresistens och så småningom blir det avtagande funktion av β- cellerna vilket leder till nedsatt insulinkänslighet och främsta orsakerna till typ II diabetes är övervikt och fetma. Det finns olika behandlingsrekommendationer för att behandla typ II diabetiker för att minska att sena komplikationer uppstår. Främst genom livsstilsförändringar som kost och fysisk aktivitet, men då dessa inte räcker till kan perorala läkemedel komma i efterhand och om inte det heller ger tillräcklig effekt kan insulinbehandling sättas in. Ca 50 % av typ II diabetiker får insulin efter 10 års sjukdom. Syftet med arbetet är att undersöka om det finns en god implikation av att sätta in insulin tidigare än det som redan är rekommenderat. Denna litteraturstudie är baserad på artiklar hämtade från databasen PubMed. Sammanlagt har fem randomiserade kontrollerade studier granskats. Resultaten visar att en HbA1c-sänkning med ca 1,5 - 2,0 % kan erhållas samt också en bibehållen β- cellfunktion vid insättning av insulin. Insulinbehandlingen bör sättas in så snart HbA1c går över 7,5 % istället för att vänta en viss tid. Den kan sättas in hos behandlingsnaiva personer med framträdande symtom eftersom insulin fortfarande sänker HbA1c och det finns inget som tyder på att insulin inte kan sättas in tidigare än det som är rekommenderat. Slutsatsen som dras är att stödja intensiv behandling som gör att HbA1c hålls på en så låg nivå det är möjligt och när målvärden för HbA1c inte kan hållas kan insulin med fördel sättas in hos typ II diabetiker som behandlats med perorala antidiabetika.

>Magister Scientiae - MSc / About 180 million people have been estimated to suffer from type 2 diabetes (T2DM) in 2006 and the annual death rate due to this disease was 3 million by that time. More than 400 medicinal plants used for the treatment of diabetes mellitus have been recorded, but only a small number of these plants have received scientific and medical evaluation to assess their efficacy. The most common plant used to treat diabetes mellitus is Hypoxis hemerocallidea (HH). The present study was undertaken to investigate the effects of Hypoxis hemerocallidea (HH) on T2DM in rats. Male Wistar rats weighing 200-250 g were used in this experiment. Hypoxis hemerocallidea (HH) corm was used as plant material in the experiment. The study was based on three parts, an acute diabetes study, chronic diabetes study and insulin secretion study. In the acute study, the rats were randomly divided into 2 groups (control and diabetes). The saline solution was added to different concentrations of HH corm to produce concentration of (50, 200, 400, 800 mg/ml). Diabetes was induced by intraperitoneal injections of STZ (65mg/kg). Two weeks after the injection (STZ 65 mg/kg), different concentrations of HHS was administered intraperitoneally after an overnight fast. The blood glucose levels were monitored in the diabetic and control rats at, 30, 60, 120, 180 and 240 minutes post injection. In the chronic study, the rats were randomly divided into 6 different groups (control, HFD, DM, DM-HH, DM-PTHH, and HH). Diabetes mellitus was then induced in the groups of diabetic rats by intraperitoneal injections of STZ (40 mg/kg) and rats were fed a high fat diet (HFD). The body weight of the rats were measured weekly for 7 weeks. An intraperitoneal glucose tolerance test (IPGTT) was performed at the end of week 6. At the end of week 7, rats were killed and serum sample were collected for determination of fatty acid and insulin. Liver and pancreatic tissue was collected for histological evaluation. In the insulin secretion study, Hypoxis hemerocallidea was tested for its effects on insulin secretion by pancreatic islet cells exposed to low (3mM) and high (20mM) glucose medium. Results of the acute study indicated that HHS at a dose 800 mg/ml decreased blood glucose levels fastest in both normal and diabetic rats reaching significance after 30 minutes and 60 minutes respectively and remained below the baseline value until 240 minutes. In the chronic study, it was illustrated that HH had no effect in normal rats on any of the parameters evaluated. Animals in the DM group gained weight the first two weeks, but thereafter began to lose weight. At the end of seven weeks the animals gained significantly less weight than the rest. Animals fed a HFD have more visceral fat compared to the control group. The visceral fat gain occurred in the absence of a significant increase in body weight. We found a markedly lower fasting glucose level in HH treated diabetic animals compared to untreated DM animals. At time zero the blood glucose level of the HFD group (5.8±0.5mmol/l) and the HH group (4.9±0.7mmol/l) were in the normal range, and were not significantly different (P > 0.05) from the control group (5.0±0.2mmol/l). After glucose load peak blood glucose levels was measured after 30 minutes in the control group (9.0±0.6mmol/l), the HFD group (9.8±0.4 mmol/l), the DM-HH group (21±5.7 mmol/l) and the DM-HHPT group (27.8±5.3 mmol/l). In the HH group the blood glucose level reached a peak at 60 minutes (7.6±0.6 mmol/l). In the DM group two peaks were recorded one after 10 minutes (27.2±7.1mmol/l) and another after 60 minutes (31±5.2 mmol/l). In the groups control, HFD, DMHH, DM-HHPT and HH groups the blood glucose level after 120 minutes were not significantly different from the time zero value. The blood glucose level after 120 minutes in the DM group (28.2±7.1 mmol/L) was significantly higher (P ≤ 0.01) than from the time zero value. Serum fatty acid levels were increased in all groups fed a high fat diet. The serum insulin levels in the HFD group (6.2 ± 0.76 μUI/ml protein; P ≤ 0.05 ), the DM group (2.0 ± 0.9 μUI/ml protein; P ≤ 0.001), the DMHH group (3.4 ± 0.7 μUI/ml protein; P ≤ 0.001) and the DM-HHPT group (3.0 ± 1.1 μUI/ml protein; P ≤ 0.001) were significantly lower than the control group. The β-cell function in the HFD group (62 ± 8 %; P ≤ 0.001), the DM group (3 ± 1 %; P ≤ 0.001), the DM-HH (11 ± 9 %; P ≤ 0.001) group and the DM-HHPT group (4 ± 2 %; P ≤ 0.001) were significantly lower than the control group. The histological observation of the liver and the pancreas in rats after 7 weeks on different dietary regimes showed some morphological changes within the liver and pancreas parenchyma of some rats. In the insulin secretion study, glucose stimulated insulin secretion in low (3mM) and high (2mM) glucose concentration. Furthermore, insulin secretion was significantly higher when the glucose concentration was increased from 3mM to 20 mM (1.10 ± 0.13 μUI/ml protein and 1.5 ± 0.17 mIU/mg protein respectively P≤ 0.01). In the presence of low HH (100 µg/ml), there was a marked increase in insulin secretion when exposure to high glucose compared to low glucose concentration, while in the presence of high HH (500 µg/ml), there was no significant different in insulin secretion in the presence of low or high glucose. In conclusion, the results of this experimental study indicate that a concentration 800 mg/kg of HHS produces maximal hypoglycaemic effect in fasted normal and diabetic rats. HH has an antidiabetic activity as it lowers serum glucose levels in T2DM rats and significantly increases glucose tolerance. It also increases body weight of diabetic rats. HH treatment was found to improve insulin secretion in pancreatic islet cells.

Bakgrund: Diabetes Mellitus typ 2 (DMT2) är en vanlig sjukdom över hela världen, den största orsaken bakom DMT2 är levnadsvanor och därför kan sjukdomen påverkas av livsstilsförändringar. Människors livskvalitet kan påverkas negativt av sjukdom och livskvaliteten kan variera stort mellan olika individer utifrån olika faktorer som hur de lever, hur de tänker och hur de hanterar olika situationer. Syfte: Syftet var att beskriva vilken betydelse livsstilsförändringar kan ha på livskvaliteten vid diabetes typ 2. Metod: Studiens design var en beskrivande litteraturstudie. Studien baserades på elva vetenskapliga artiklar som söktes fram via databasen PubMed. För att analysera artiklarnas resultat användes en tematisk dataanalys. Huvudresultat: I vissa fall bidrog livsstilsförändringar inte till några större skillnader i livskvalitet hos personer med DMT2 och i andra fall gav det positiva effekter. Över lag gav livsstilsförändringarna någon typ av positiv effekt inom en eller flera undergrupper för livskvalitet. Slutsats: Livskvalitet är något som skattas individuellt och kan innebära olika från person till person. Därför varierar även betydelsen av livsstilsförändringar relaterat till livskvalitet. Det är viktigt att ha denna kunskap som sjuksköterska för att ha förståelse för patienter och kunna individanpassa vården och det stöd som ges. / Background: Type 2 diabetes (T2D) is a common disease all over the world and the biggest reason behind T2D is lifestyle behavior and because of that it can be affected by making lifestyle changes. The quality of life can be affected negatively by disease and the quality of life can differ between individuals depending on factors such as lifestyle, mindset and coping strategies. Aim: The aim of the study was to describe how the quality of life can be affected by lifestyle changes among type 2 diabetes patients. Method: The design of the study was a descriptive literature review. The study was based on eleven articles that were found searching the database PubMed. The data analysis that was used to analyze the results of the articles was a thematic data analysis. Main Result: In some cases, the lifestyle changes did not tribute to any significant changes in the quality of life amongst people with T2D and in other cases it had a positive effect. The lifestyle changes did overall give some sort of positive effect on one or more of the subscales of quality of life. Conclusion: The quality of life is very individual and has a different meaning to each and everyone. Because of that, the lifestyle changes may have various effect on the quality of life. This knowledge is important to have as a nurse to be able to give patient-centered care and to support and understand the patients’ needs.

Bakgrund: Diabetes mellitus är en folksjukdom som kan leda till tidig död, främst på grund av hjärt- och kärlsjukdom. Diabetes mellitus har två typer av sjukdomar, vilket är typ ett och två. Båda är kända med förhöjda blodsockernivåer. Diabetes mellitus typ två handlar om insulinresistens och delvis insulinbrist. Sjukdomen kan yttra sig med två typer av komplikationer, nämligen mikrovaskulära och makrovaskulära. Behandlingen av Diabetes mellitus typ två är främst medicinering, kost och motion som förändrar livsstilen. Här är egenvård mycket viktigt och sjuksköterskan måste undervisa och informera på rätt sätt. Syfte: Syftet med studien är att beskriva patientens upplevelse av att leva med diabetes mellitus typ två. Metod: Metod som används är en litteraturöversikt med nio vetenskapliga artiklar. Datainsamlingen gjordes med sökord i databaserna CINAHL och Medline. Resultat: Resultatet visar att patientens upplevelser av att behöva göra förändringar i livsstilen handlar om att få stöd och känna hopp i framtiden i förhållande till diabetes mellitus typ två. Kost- och motionsförändringar påverkar patientens upplevelser och känslor. Patienten kan även ha emotionella upplevelser vid diabetes mellitus typ två, vilket kan vara känslor som skuld och skam. I det här läget ska patienten acceptera sjukdomen. Patienten kan ha upplevelser som ånger, motivationsbrist, hopplös, utmaning, ångest, skuld, skam och svårt att acceptera sjukdomen.y Diskussion: Patienten med diabetes mellitus typ två bör ändra sin kost och motion för att kunna få en bättre hälsa. Samtidigt ska sjuksköterskan inte glömma bort patientens upplevelser som kan leda till olika konsekvenser. Kost och motion har varit en utmaning för vissa patienter i livsstilen, som kan associeras med livslidande.

Bakgrund: Diabetes typ 2 är en sjukdom som ökar världen över. Största orsaken till att diabetes typ 2 ökar beror på fetma hos befolkningen. Diabetes typ 2 är en kronisk sjukdom som inte går att bota och behandlas i först hand med livsstilsförändringar såsom goda kostvanor och regelbunden fysisk aktivitet.  Syfte: Att beskriva personers upplevelser av att leva med diabetes typ 2. Metod: En litteraturöversikt valdes som metod där tio kvalitativa vetenskapliga originalartiklar inkluderades i resultatet. Litteratursökningen genomfördes i databaserna Cinahl Complete och PubMed. Artiklarna analyserades med hjälp av Fribergs (2017) fyra steg.  Resultat: Ur resultatet framkom fyra teman: känslomässig påverkan, begränsningar i vardagslivet, förnekelse eller acceptans och vikten av information.  Slutsats: Personerna upplevde svårigheter med att leva med diabetes typ 2. Det underlättade för personer att få stöd och information av sjuksköterskan vilket gav dem motivation till att främja deras hälsa genom livsstilsförändringar. / Background: Type 2 diabetes is a disease that is on the rise worldwide. The main reason for the increase in type 2 diabetes is due to obesity in the population. Type 2 diabetes is a chronic that cannot be cured and is treated primarily with lifestyle changes such as good diet and physical activity. Aim: To describe people’s experiences of living with type 2 diabetes. Method: A literature review was chosen where ten qualitative scientific original articles were included in the results. The literature search was performed in the databases Cinahl Complete and Pubmed. The articles were analyzed with the help of Fribergs (2017) four steps. Results: The results revealed four themes: emotional impact, limitation in everyday life, denial and acceptance, the importance of information. Conclusion: The people experienced difficulties in living with type 2 diabetes. It made it easier for the people to get support and information from the nurse, which gave them motivation to promote their health through lifestyle changes.

Bakgrund: Diabetes mellitus typ 2 (DMT2) är en folkhälsosjukdom som finns runt om i världen. Diabetes är en sjukdom som kan bli livshotande om patienten inte får sjukvård. Den klassas som en icke-smittsam folksjukdom, förutom de kroppsliga skadorna som DMT2 kan det även orsaka ekonomiska svårigheter för patienten samt för hälso- och sjukvården. DMT2 sjukdomen påverkar patienten negativt då de orsakar dagliga problem. Långsiktigt kan det även bidra till komplikationer och för att kunna förebygga behöver patienten kunskap kring sjukdomsinsikten samt riskfaktorer som kan uppstå och vilken behandling som kan vara effektiv för deras livskvalité. Syfte: Att beskriva hur personer med diabetes typ 2 upplever sin egenvård. Metod: Översikten för litteratursökningen gjordes med hjälp av två databaser Cinahl Complete och PubMED där ett urval av 11 styckna vetenskapliga artiklar som är inriktade i kvalitativ metod valdes ut. Resultat: Litteraturöversikten visar på 4 huvudområden: hantering av blodsockervärdet, kosthantering, fysisk aktivitet och stöd. Slutsats: I litteraturöversikten har författarna kommit fram till att patienter med diabetes typ 2 behöver mycket stöd både hälso- och sjukvården men även från närstående och vänner. I litteraturöversikten finner författarna även att levnadsvanorna har en stor inverkan på patienterna om de utför en livsstilsförändring som gynnar de kan de leva ett liv av kvalité. / Background: Type 2 diabetes mellitus (DMT2) is a public health disease that is found around the world. Diabetes is a disease that can be life-threatening if the patient does not receive medical care. It is classified as a non-communicable public disease, in addition to the bodily injuries such as DMT2, it can also cause financial difficulties for the patient as well as for health care. DMT2 disease negatively affects the patient as they cause daily problems. In the long term, it can also contribute to complications and in order to be able to prevent it, the patient needs knowledge about the disease insight as well as risk factors that may arise and which treatment can be effective for their quality of life. Aim: To describe how people with type 2 diabetes experience their self-care. Method: The overview for the literature search was made with the help of two databases Cinahl Complete and PubMED, where a selection of 11 scientific articles that focus on qualitative methods were selected Results: The literature review shows 4 main areas: management of blood sugar value, diet management, physical activity and support. Conclusion: The literature review has concluded that patients with type 2 diabetes need a lot of support from both health care but also from relatives and friends. In the literature review, it is also found that lifestyle habits have a great impact on patients, if they make a lifestyle change that benefits them, they can live a life of quality.

Bakgrund Diabetes typ 2 är en folksjukdom som ökar globalt. Hanteringen av diabetes typ 2 innebär ett stort ansvar för individen för att inte utveckla allvarliga komplikationer. Sjuksköterskan har ett ansvar att utbilda och motivera individer med diabetes typ 2 för att förenkla utförandet av olika livsstilsförändringar. Syfte Syftet var att belysa erfarenheter av motivation till genomförandet av livsstilsförändringar hos vuxna individer med diabetes typ 2. Metod Studien utfördes utifrån en icke-systematisk design och för att kunna besvara syftet sammanställdes 15 vetenskapliga artiklar. Artiklarna inhämtades från databaserna PubMed och CINAHL med hjälp av relevanta sökord. Artiklarna kvalitetsgranskades sedan utifrån Sophiahemmet Högskolas bedömningsunderlag, vidare utfördes en integrerad dataanalys för att identifiera olika kategorier. Resultatartiklarna indelades i två huvudkategorier med tillhörande underkategorier. Resultat De två huvudkategorierna som identifierades var inre motivation och yttre motivation. Sammanfattningsvis avhandlar den inre motivationen bland annat om hur känslor kring att leva med diabetes typ 2 och hur rädslan för komplikationer bidrog till att individer gjorde livsstilsförändringar. Den yttre motivationen handlar om stödet omgivningen bidrog med samt hur den kulturella och socioekonomiska faktorn hade en betydande roll för hur individer kunde hantera diabetes typ 2. Individerna ansåg att kost och fysisk aktivitet utgjorde hinder för att genomföra livsstilsförändringar, till exempel att kroppsliga besvär var ett hinder till att utöva fysisk aktivitet. Slutsats De motiverande faktorerna skilde sig åt mellan individerna. Av sjuksköterskan krävs ett personcentrerat förhållningssätt som utgår från patientens nuvarande livssituation för att på bästa sätt ge anpassad information och råd som betraktas vara rimliga i förhållande till individens förutsättningar. / Background Diabetes mellitus type 2 is a public health disease that is increasing globally. The management of diabetes mellitus type 2 requires a great responsibility for the individual, in order to not develop serious complications. The nurse has a responsibility to educate and motivate individuals with diabetes mellitus type 2 to simplify the implementation of different lifestyle changes. Aim The study aimed to explore experiences of motivation for the implementation of lifestyle changes in adults with diabetes mellitus type 2. Method The design of the study was a non-systematic review where 15 scientific articles were used to answer the aim. The articles were gathered using relevant keywords in the databases PubMed and CINAHL. The articles were quality reviewed by using Sophiahemmet University´s assessment form. An integrated analysis was used to identify categories. The result articles were divided into two main categories with associated subcategories. Results Two main categories were identified in the result, those were internal motivation and external motivation. In summary, the internal motivation refers to the feelings of living with diabetes mellitus type 2. Further, it includes how the fear of complications contributed to making certain lifestyle changes to avoid complications. Support from the surroundings is important to manage diabetes mellitus type 2, which can be referred to external motivation. Cultural and socioeconomic factors were also important in how individuals manage their diabetes mellitus type 2. Individuals considered that diet and physical activity were barriers and therefore had difficulties implementing changes. For example, that physical problems were a barrier to practice physical activity. Conclusions There were differences in which factors that were considered motivating for the individuals. The nurse requires to have a person-centered approach based on the patient´s current life situation, to provide adjusted information and advice that is considered reasonable in relation to the individual’s capability.

Diabetes typ 1 och 2 är idag en folksjukdom och antalet nyinsjuknade ökar i samma omfattning som fetmaepidemin. Dess behandling är emellertid komplex varför föreliggande litteraturstudie syftade till att beskriva vuxna individers erfarenheter av att leva med diabetes typ 1 och 2. Litteratursökningen utfördes i databaserna CINAHL och PubMed. Både kvantitativa och kvalitativa studier (N=10) inkluderades vilka kvalitetsgranskades av båda författarna oberoende av varandra med hjälp av ett modifierat granskningsprotokoll. Resultatet visade att individernas erfarenheter av att leva med sjukdomen berörde sex olika teman; plasmaglukosnivån, copingstrategier, insulinpump/insulinpenna/antidiabetikum, kost, stöd och oro. Individer med diabetes typ 1 eller 2 upplevde att de oftast fick för lite information angående sjukdomen varför deras oro över akuta- och senkomplikationer ökade. Kosthållningen beskrevs också svår och problemfylld när övriga familjemedlemmar motsatte sig denna. Individerna betonade därför vikten av stöd från familj och anhöriga.Nyckelord: Diabetes Mellitus typ 1, diabetes mellitus typ 2, erfarenhet, litteraturstudie, omvårdnad / Today, diabetes type 1 and 2 are seen as a public health issue, and the number of newly diagnosed are increasing to the extent of obesity. The treatment is, however, complex why the literature review presented aims at describing adult individuals experience about living with diabetes type 1 and 2. The literature search was performed in the databases CINAHL and PubMed. Both quantitative and qualitative studies (N=10) were included, and quality rated, by both authors independently of each others, by means of a modified review record. The result showed that individuals experience about living with diabetes type 1 and 2 concerned six different themes: plasma glucose level, coping strategies, insulin pump/insulin pen/antidiabeticum, diet, support and anxiety. Individuals diagnosed with diabetes type 1 or 2 experienced that they didn’t receive enough information regarding the disease, which resulted in worries aboute acute- and late- complications. A majority experienced the diet restrictions as difficult and troublesome because the family opposed the new diet. The individuals experienced that support from the family and relatives were important, but a balance was an aim. Keywords: Diabetes Mellitus type 1, diabetes mellitus type 2, experiences, nursing, review