Objetivos. Investigar a associação entre consumo alimentar, índice glicêmico (IG) da dieta habitual com glicemia e insulinemia de jejum, resistência à insulina (HOMA R) e alteração da homeostase glicêmica (AHG: glicemia de jejum alterada - GJA, tolerância à glicose diminuída - TGD e diabetes mellitus tipo 2). Indivíduos e métodos. 1.054 nipo-brasileiros residentes em Bauru, ambos os sexos, 30 a 90 anos, primeira e segunda gerações, que participaram de inquérito transversal conduzido em 2000, sem diagnóstico prévio de AHG e/ou uso de hipoglicemiantes orais/insulina. Para avaliação da dieta habitual, utilizou-se questionário quantitativo de freqüência alimentar, previamente validado, com o auxílio do programa Dietsys versão 4.0. Os fatores dietéticos foram ajustados pelas calorias totais pelo método residual, após transformação logarítmica. As variáveis independentes foram inicialmente selecionadas segundo correlação de Pearson com glicemia e insulinemia de jejum ou HOMA R (variáveis dependentes contínuas) com valor de p<0,20. A associação entre nutrientes/ alimentos com as variáveis dependentes contínuas foi avaliada em modelos de regressão linear múltiplos. Modelos de regressão logística múltiplos foram utilizados para investigar a relação entre fatores dietéticos (tercis) com AHG, ajustados por fatores de confusão. Resultados. Após ajuste múltiplo, houve associações inversas entre o consumo dos grupos de laticínios integrais (g/dia), doces (g/dia), IG da dieta e glicemia de jejum (mg/dl). Relação inversa entre o consumo de IG da dieta e HOMA R também foi observada. Verificou-se razão de chances - RC (IC 95%) - para GJA de 1,70 (1,06 - 2,74) no último tercil de consumo de fibras totais em que as principais fontes alimentares foram o arroz polido, pão branco e frutas/sucos de frutas. Efeito protetor entre o tercil intermediário do consumo de vegetais [0,61 (0,38 - 0,98)] foi observado para TGD. Conclusão. Em nossa população de estudo, a fibra dietética proveniente do consumo excessivo de arroz polido, pão branco, frutas e sucos representou risco para AHG. Por outro lado, observou-se efeito protetor do maior consumo de vegetais para TGD. / Objective. To investigate the effects of food intake and dietary glycemic index (GI) on fasting plasma levels of glucose and insulin, homeostasis model assessment of insulin resistance (HOMA R) and impaired glucose disturbance - IGD (impaired fasting glucose - IFG, impaired glucose tolerance - IGT and diabetes mellitus type 2). Subjects and methods. 1,054 Japanese-Brazilians living in Bauru, of both genders, 30 to 90 years-old, first- and second-generation, who completed all the information for the cross-sectional survey in 2000, without previous diagnosis of IGD and/or use of oral hipoglycemic medication/insulin. Food consumption was assessed using a validated food frequency questionnaire, with the aid of the software Dietsys 4.0. All dietary factors were log-transformed and adjusted for total energy intake by residual method. The dependent variables were first selected using Pearson correlation with fasting plasma levels of glucose and insulin or HOMA R (continuous independent variables), with p<0.20. The associations between selected nutrients/foods and the continuous independent variables were assessed using multiple linear regression models. Logistic regression models were used to investigate the relationship between dietary factors (tercile) and IGD, while adjusting for confounding factors. Results. After multiple adjustments, intakes of whole dairy products and sweets (g/day) and dietary GI were inversely correlated with fasting glucose levels (mg/dl). Dietary GI was also inversely correlated with HOMA R. The odds ratio (95% confidence interval) for IFG was 1.70 (1.06 - 2.74) in the highest tercile of total dietary fiber (main food sources: white rice and bread, fruits/fruit juices). The second tercile of vegetable intake was associated with a risk reduction of IGT [0.61 (0.38 - 0.98)]. Conclusion. In our study population, the intake of total dietary fiber, largely attributable to high intakes of white rice, white bread, fruits/fruit juices, was positively associated with risk of IGD. On the other hand, a protective effect was observed for higher intake levels of vegetables

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-09-04T12:28:16Z No. of bitstreams: 0 / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-09-04T13:24:00Z (GMT) No. of bitstreams: 0 / Made available in DSpace on 2018-09-04T13:24:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-06-26 / Introdução: Quedas em idosos estão relacionadas a lesões e altos custos para o sistema de saúde. Os adultos mais velhos que desenvolvem diabetes tipo 2 têm maior chance de cair. A queda nesses indivíduos está relacionada à neuropatia, prejuízos somatossensoriais, cognitivos, visuais e vestibulares e declínio funcional. A força muscular e o comprometimento do equilíbrio podem aumentar o risco de quedas e a fadiga muscular reduz a capacidade de gerar força. Portanto, o objetivo do presente estudo foi comparar os padrões de ativação muscular e as medidas de equilíbrio durante o teste de equilíbrio de apoio unipodal em mulheres idosas diabéticas e não diabéticas, antes e após a tarefa de ficar na ponta dos pés até a fadiga. Métodos: No presente estudo de caso-controle, 54 mulheres idosas foram divididas em dois grupos: diabetes tipo 2 (n = 28; 70 ± 6 anos) e sem diabetes tipo 2 (n = 26; 71 ± 8 anos). A eletromiografia de superfície foi utilizada para avaliar a ativação do tibial anterior (TA) e do gastrocnêmio medial (GM) e uma plataforma de força foi utilizada para avaliar o equilíbrio durante o teste de equilíbrio unipodal antes e após a tarefa de fadiga. Teste t independente foi utilizado para avaliar as diferenças entre os grupos. Foi adotado nível de significância de 0,05. A curva ROC foi usada para determinar a responsividade e a acurácia de cada variável individualmente para discriminar mulheres diabéticas tipo 2 de idosas não diabéticas. Resultados e Discussão: O grupo de mulheres idosas com Diabetes Tipo 2 apresentou valores de RMS_ML, RMS_AP e TA_MEAN mais elevados do que o grupo de mulheres idosas não diabéticas, tanto antes quanto depois da tarefa de fadiga. Não foram observadas diferenças significativas intragrupos antes e depois da fadiga. Os valores RMS_ML_PRE, RMS_ML_POST, RMS_AP_PRES, RMS_AP_POST, TA_MEAN_PRE e TA_MEAN_PRE podem discriminar mulheres idosas diabéticas tipo 2 de a mulheres idosas não diabética. Conclusões: As mulheres idosas diabéticas apresentaram pior equilíbrio em apoio unipodal, sem influência da tarefa de fadiga. Diabetes tipo 2 levou a uma ativação desequilibrada dos músculos da perna com aumento da ativação da TA. Além disso, o estudo identificou ponto de corte para discriminar o equilíbrio postural de idosas diabéticas. / Background and Purpose: Falls in older adults are related to injuries and high costs to the health care system. Older adults who develop type 2 diabetes have increased chance of falling. Falling in these individuals relates to neuropathy, somatosensory, cognitive, visual and vestibular impairments, and functional decline. Already know that muscle strength and balance impairments can increase the risk for falls and muscle fatigue reduces the capacity to generate force. Therefore, the objective of the present study was to compare muscle activation patterns and balance measurements during one-leg stance balance test in diabetes and nom diabetes older women before and after completion of a fatiguing rise-to-toes task. Methods: In the present case-control study, 54 older women were divided into two groups: type 2 diabetes (n=28; 70±6 years old) and non-type 2 diabetes (n=26; 71±8 years old). A force platform was used to assess balance during 1-legged stance, and surface electromyography was used to assess the tibialis anterior (TA) and gastrocnemius medialis (GM) activation. Independent t-test was used to assess differences between groups. The significance was set at α=0.05. The Receiver Operating Characteristic (ROC) curve was used to determine the responsiveness and the accuracy of each variable individually for discriminate type 2 diabetic older women from non type 2 diabetic older women. Results and Discussion: The Type 2 Diabetes older woman group had higher RMS_ML, RMS_AP, and TA_MEAN values than Nom-Diabetes older woman group, for both, before and after the fatiguing task. No significant differences were observed intragroups before and after fatiguing task. RMS_ML_PRE, RMS_ML_POST, RMS_AP_PRES, RMS_AP_POST, TA_MEAN_PRE and TA_MEAN_PRE values could discriminate type 2 diabetic older women than non-diabetic older women. Conclusions: Diabetic older women showed worse one-leg stance balance than non-diabetic, with no influence of the fatiguing rise-to-toes task. Type 2 Diabetes leaded to an unbalanced activation of leg muscles with increased TA activation. Moreover, the study identified cutoff point to discriminate diabetic older women’s postural balance.

Orientador: Bruno Geloneze Neto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T03:40:20Z (GMT). No. of bitstreams: 1 Oliveira_MariaSaude_M.pdf: 4379495 bytes, checksum: b6a2152a8da2c7dc1bd4d9f45131cba5 (MD5) Previous issue date: 2013 / Resumo: Objetivo: Estimar o impacto do envelhecimento e do diabetes na sensibilidade à insulina, função da célula beta, adipocitocinas e produção de incretina Métodos: Foram realizados clamps hiperglicêmicos, testes de arginina e testes de refeição padrão em 50 pacientes não obesos para medir a sensibilidade à insulina e secreção de insulina, assim como os níveis plasmáticos do glucagon, GLP-1 e GIP. Os pacientes com diabetes e do grupo controle saudáveis foram divididos nos seguintes grupos: meia idade com diabetes tipo 2 (MI-DM2), idosos com diabetes tipo 2 (I-DM2), meia idade ou idosos com tolerância normal à glicose (MI-TNG, I-TNG). Resultados: A sensibilidade à insulina (SI), determinada pelo modelo de avaliação da homeostase, taxa de infusão de glicose e pela sensibilidade à insulina a glicose oral, foi reduzida no grupo de idosos e nos grupos com DM2, comparados com o grupo de meia idade com tolerância normal à glicose, mas foi similar no grupo MI-DM2 e grupo I-DM2. O índice insulinogênico, a primeira e segunda fase de secreção de insulina e o índice de disposição, com exceção da resposta da insulina à arginina, foram reduzidos com o envelhecimento e nos grupos com DM2. A produção pós-prandial média de glucagon no tempo total de 0 - 180 minutos foram maiores no grupo de DM2 comparado ao grupo de TNG, sendo que na primeira hora da produção de glugagon o grupo de I-DM2 apresentou uma média mais elevado em relação ao grupo de MI-DM2. Embora a produção de GLP-1 tenha sido reduzida no grupo I-DM2, nenhuma diferença entre os grupos foi observada em relação à produção de GIP. Conclusão: O diabetes e o envelhecimento desencadearam uma redução da sensibilidade à insulina em pacientes não obesos. A produção de insulina foi reduzida com o envelhecimento e exacerbada pela condição do diabetes. As deficiências associadas ao envelhecimento se sobrepõe a fisiopatologia do diabetes, particularmente relacionada à produção de GLP-1. Por outro lado, a secreção de insulina independente da glicose foi preservada. O entendimento desta complexa relação entre envelhecimento e diabetes poderia ajudar no desenvolvimento de terapias farmacológica baseada em fisiopatologia / Abstract: Objective: To estimate the impact of aging and diabetes on insulin sensitivity, beta-cell function, adipocytokines, and incretin production. Methods: Hyperglycemic clamps, arginine tests and meal tolerance tests were performed in 50 non-obese subjects to measure insulin sensitivity (IS) and insulin secretion as well as plasma levels of glucagon, GLP-1 and GIP. Patients with diabetes and healthy control subjects were divided into the following groups: middle-aged type 2 diabetes (MA-DM), elderly Type 2 diabetes (E-DM) and middle-aged or elderly subjects with normal glucose tolerance (MA-NGT or E-NGT). Results: IS (insulin sensitivity), as determined by the homeostasis model assessment glucose infusion rate and oral glucose insulin sensitivity, was reduced in the aged and DM groups compared with MA-NGT, but similar in MA-DM and E-DM groups. Insulinogenic index, first and second phase of insulin secretion and the disposition indices, except insulin response to arginine, were reduced in the elderly and DM groups. The average postprandial glucagon production on the interval of 0-180 min was higher in DM groups compared to NGT groups, furthermore noticed that in the first hour of glucagon secretion, group E-DM had a higher average value compared to group MA-DM. Whereas the GLP-1 production was reduced in A-DM, no differences between groups were observed in GIP production. Conclusions: In non-obese subjects, diabetes and aging impair insulin sensitivity. Insulin production is reduced by aging, and diabetes exacerbates this condition. Aging associated defects superimposed diabetic physiopathology, particularly regarding GLP-1 production. On the other hand, the glucose-independent secretion of insulin was preserved. The knowledge of the complex relationship between aging and diabetes could support the development of physiopathological and pharmacological based therapies / Mestrado / Clinica Medica / Mestra em Ciências

Bakgrund: Diabetes är en folksjukdom, som ökar i samhället och i världen. Diabetes typ 2 kan förebyggas, fördröjas eller lindras med hjälp av hälsosamma levnadsvanor, så som kost och motion. Livsstilsbehandling är därför grundläggande för att uppnå detta. Syfte: Att beskriva distriktssköterskans erfarenheter av att främja hälsosamma levnadsvanor, kost och motion, hos patienter med diabetes typ 2. Metod: En empirisk studie med kvalitativ intervjumetod där sju distriktssköterskor deltog i intervjuer. Resultat: I studien framkom vikten av distriktssköterskornas erfarenheter och syn på att främja hälsosamma levnadsvanor, kost och motion, för att kunna hjälpa och motivera patienter med diabetes typ 2. Att främja hälsosamma levnadsvanor, hos patienter med diabetes typ 2, beskrevs som grunden i behandlingen. En mycket viktig uppgift som var nödvändig för att förhindra samt minska risken för komplikationer till sjukdomen. Distriktssköterskorna har erfarenheter av, och möjligheter till, att främja hälsosamma levnadsvanor på flera olika sätt. Arbetet med att främja hälsosamma levnadsvanor skedde individuellt, i grupp och med hjälp av skriftlig information. Distriktssköterskorna hade även erfarenhet och var medvetna om olika hinder för att kunna främja hälsosamma levnadsvanor. Slutsats: Distriktssköterskorna bör se varje patient som en unik individ och därefter anpassa arbetet med att främja hälsosamma levnadsvanor. Uppföljning samt kontinuitet behövs för att patienten ska få motivation till livsstilsförändringar och bibehålla dessa. / Background: Diabetes is a people's disease that increases in society and in the world. Diabetes type 2 can be prevented, delayed or alleviated using healthy living habits, such as diet and exercise. Lifestyle treatment is therefore essential for achieving this. Purpose: To describe the district nurse's experience of promoting healthy living habits, diet and exercise, in type 2 diabetes patients. Method: An empirical study with qualitative interview method where seven district nurses participated in interviews. Results: The study highlighted the importance of district nurses' experiences and views on promoting healthy living habits, diet and exercise, to help and motivate patients with type 2 diabetes. To promote healthy living habits, in type 2 diabetes patients, are described as the basis of treatment. A very important task that is necessary to prevent as well as reduce the risk of complications to the disease. District nurses have experience and opportunities to promote healthy living habits in a variety of ways. Work on promoting healthy living habits is done individually, in groups and with the help of written information. District nurses also have experience and are aware of various obstacles to promote healthy living habits. Conclusion: District nurses should see each patient as a unique individual and then adjust the work to promote healthy living habits. Follow-up and continuity are needed to give the patient motivation for lifestyle changes and maintain them.

Ageing population’s increasing ratio is alarming and the needs of elder persons are increasing day by day. Fast increase in ageing population means the growing of chronic diseases as well. Diabetes type 2 is a chronic disease which commonly found in elder persons. Technological innovations in Health care sector playing an enormous role in improving the healthy life of all humans. Use of latest technologies in perceiving the health services are now common. Each technology in this era is facilitating in many ways, same is the case with mobile phone which can provide multiple functionalities for the betterment of elderly life. The focus of this study is to investigate the reasons of less use of mobile phone in elderly life and what other functionalities elderly want in coming mobile phones. The results of this study would be supportive in understanding the problems of diabetes type 2 patients in using mobile phone. This study would also be helpful for the manufacturers in developing the mobile phones according to the needs of elder persons. The analysis of this research work depends on three study stages. It starts from the literature review, in which we learned the effects of diabetes on elder persons. It also includes the usability features of mobile phone which necessary for implementing the future functionalities with elderly perspective. On the basis of literature review we designed the questionnaire and prepare the interviews. Interviews were conducted with two health care professionals and questionnaires with the citizens of county of Blekinge. We believe that our analysis will be helpful for both elderly and mobile phone manufacturing companies and they will also be supportive in increasing the quality of life of elderly.

Titel: Att leva med diabetes mellitus typ 2.  Bakgrund: Diabetes mellitus typ 2 (DMT2) är ett globalt problem och fler personer insjuknar årligen. Egenvård är en central del av behandlingen för dessa personer. Att förstå livsstilsförändringar, behandlingar och egenvården hos dessa personer bidrar till ökad kunskap inom hälso- och sjukvården.   Syfte: Att beskriva personers erfarenheter av att leva med diabetes mellitus typ 2.   Metod: Litteraturöversikt med artiklar av kvalitativ design baserad på 12 vetenskapliga artiklar från databaserna Cinahl och MedLine.   Resultat: Resultatet presenteras i två huvudteman egenvård och information vid diabetes mellitus typ 2 och påverkan av diabetes mellitus typ 2 i livet med respektive underkategorier. Det fanns erfarenhet av bristande och otillräcklig information av hälso- och sjukvården. Erfarenheter fanns av att närstående gav bra information och under gruppbaserad utbildning reflekterades erfarenheter av att leva med DMT2. Resultatet visade att egenvården innefattade en del svårigheter som ändrade kostvanor, fysisk aktivitet, kulturella aspekter och förändrad livsstil.   Slutsats: DMT2 är en global och livslång sjukdom där livsstilsförändringar bör genomföras. Erfarenheter av att det var svårt att genomföra livsstilsförändringar där kostvanor visade sig vara det svårast att anpassa sin DMT2 till. Vidare forskning kring erfarenheter hos personer med DMT2 bidrar till ökad kunskap för sjuksköterskan men även allmänheten. Vidare forskning av personer med DMT2 och hur kultur påverkar egenvården kan ge ökad kunskap till sjuksköterskan och allmänheten.   Nyckelord: Diabetes mellitus typ 2, diabetes typ 2, livsstil, patienters erfarenheter, egenvård. / Title: Living with diabetes mellitus type 2.    Background: Type 2 diabetes mellitus (DMT2) is a global problem and more people are getting sick every year. Self-care is a central part of the treatment for these people. Understanding the lifestyle changes, treatments and self-care of these people contributes to increased knowledge in health care.  Aim: Describing people's experiences of living with type 2 diabetes mellitus.  Method: A qualitative literature review. Based on 12 scientific articles collected from Cinahl and MedLine.    Results: The results are presented in two main themes of self-care and information in diabetes mellitus type 2 and the impact of diabetes mellitus type 2 in life with the respective subcategories. There was experience of inadequate and insufficient information from the health service. There was experience that close relatives provided good information and during group-based training, experiences of living with DMT2 were reflected. The results showed that self-care included some difficulties such as changing dietary habits, physical activity, cultural aspects and changing lifestyles.  Conclusion: DMT2 is a global and lifelong disease where lifestyle changes should be implemented. Experiences that it was difficult to implement lifestyle changes where dietary habits proved to be the most difficult to adapt your DMT2 to. Further research on the experiences of people with DMT2 contributes to increased knowledge for the nurse but also the public. Further research of people with DMT2 and how culture affects self-care can provide increased knowledge to the nurse and the public.   Keywords: Diabetes mellitus type 2, diabetes type 2, lifestyle, patient experience, self care.

Bakgrund: Diabetes mellitus är en global folkhälsosjukdom som 2019 orsakade 1,5 miljoner dödsfall världen över. Diabetes typ 2 orsakas främst av livsstilsfaktorer som fetma, ohälsosam kost och fysisk inaktivitet. Förändring av livsstilen är nödvändig i behandlingen och är en krävande process för många individer. Syfte: Att beskriva personers erfarenheter av livsstilsförändringar vid diabetes mellitus typ 2. Metod: Litteraturstudie baserat på tio kvalitativa artiklar som analyserats med hjälp av Fribergs femstegsmodell. Studierna kvalitetsgranskades med Olsson och Sörensens bedömningsmall för kvalitativa studier. Databaserna PubMed och Cinahl användes för att hitta relevanta artiklar till studien. Resultat: Resultatet sammanställdes i två huvudkategorier “Betydelsen av stöd” och “Betydelsen av motivation” samt fem subkategorier som beskriver olika faktorer som påverkar personer med diabetes typ 2 att genomföra livsstilsförändringar. Konklusion: Personer med diabetes typ 2 upplever livsstilsförändringar som en komplex uppgift och är i behov av stöd och motivation. För att främja god preventiv hälsa och egenvården hos personer med diabetes typ 2, kan vidare forskning inom den personcentrerade vården med beaktning för omgivande faktorer vara av betydelse. / Background: Diabetes mellitus is a global public health disease that 2019 caused 1.5 million deaths worldwide. Type 2 diabetes is mainly caused by lifestyle factors such as obesity, unhealthy diet and physical inactivity. Lifestyle change is necessary in the treatment and is a demanding process for many individuals. Aim: The aim of this study is to describe people with diabetes mellitus type 2’s experiences of lifestyle changes. Method: Literature study based on ten qualitative articles analyzed using Friberg's five-step model. The studies were quality reviewed with Olsson and Sörensen's assessment template. PubMed and Cinahl were the databases used to find relevant articles. Results: The results were compiled into two headings “The importance of support” and “The importance of motivation” as well as five subcategories that describe factors that influence people with diabetes type 2 to implement lifestyle changes. Konklusion: For people with diabetes type 2 lifestyle changes are considered a complex task and they are in need of support and motivation. In order to promote good preventive health and selfcare in people with diabetes type 2 , further research in personcentered care with regard to surrounding factors may be important.

Bakgrund: Den äldre befolkningen ökar och fler drabbas av sjukdomen diabetestyp 2, detta påverkar deras hälsa och välbefinnande. Tidigare forskning visar attdiabetes påverkar äldres liv psykiskt och fysiskt. Personcentrerad vård ärbetydelsefullt för att uppnå bättre behandlingsresultat. Forskning om äldresupplevelser av livet med diabetes kan ge en ökad förståelse hos vårdgivaren vilketkan skapa bättre möjligheter till personcentrerad vård.Syfte: Att belysa äldres upplevelser av att leva med diabetes mellitus typ 2.Metod: Litteraturstudie som baseras på 11 kvalitativa studier. Datainsamling hargenomförts via databaserna PubMed och CINAHL. Inspiration har tagits frånGraneheim och Lundmans metod för innehållsanalysen.Resultat: Dataanalysen resulterade i tre teman och varje tema delades in i tvåsubteman; Känslomässig upplevelse (rädsla och frustration), upplevelse avständigt kämpande (mål och hälsa, motivation till behandling) och upplevelse avstöd från omgivning (mötet med sjukvårdspersonal, mötet med familj och vänner).Konklusion: Litteraturstudien har visat att äldres upplevelser av att leva medsjukdomen är negativa men positiva upplevelser framkommer också. Dessaupplevelser är individuella men likheter finns också och detta beror på olikafaktorer. Det finns få studier om äldres upplevelser av att leva med diabetesmellitus typ 2, därför anses personcentrerad vård viktig i behandlingen samt merforskning för ökad kunskap. / Background: The elderly population is increasing and more people suffer from thedisease type 2 diabetes, this affects their health and wellbeing. Previous researchshows that diabetes affects older people's life mentally and physically. Personcenteredcare is important for achieving better treatment results. Research onelderly people's experiences of life with diabetes could provide a betterunderstanding of the healthcare providers, which can create better opportunitiesfor person-centered care.Objective: To highlight elderly people's experiences of living with diabetesmellitus type 2.Method: A literature review based on 11 qualitative studies. Data collection wasconducted via PubMed and CINAHL. Inspiration has been taken from Granheimand Lundman's method for content analysis.Results: Data analysis resulted in three themes and each theme was divided intotwo subthemes; emotional experience (fear and frustration), experience ofconstantly struggling (goals and health, motivation for treatment) and theexperience of support from the surroundings (the meeting with the medical staff,meeting with family and friends).Conclusion: The literature has shown that older people's experiences of livingwith the disease are negative but positive experiences also emerged. Theseexperiences are individual but there are also similarities and this is due to variousfactors. There are few studies on elderly people's experiences of living with type 2diabetes mellitus, therefore person-centered care is vital in treatment and moreresearch for greater knowledge

Bakgrund: Diabetes typ 2 är en kronisk folkhälsosjukdom som beror på att upptaget av insulin i kroppsvävnaden är nedsatt. Diabetes typ 2 kan medföra många komplikationer, både akuta och sena. Det finns många faktorer som ökar risken för sjukdomen, bland annat livsstilsfaktorer. Fysisk inaktivitet och ohälsosam mat är exempel på livsstilsfaktorer som ökar risken för att bli drabbad av sjukdomen. Syfte: Syftet med denna litteraturöversikt var att beskriva patienters upplevelse av livsstilsförändringar vid diabetes typ 2. Metod: Litteraturöversikt där tio vetenskapliga artiklar analyserats från databaserna PubMed och Cinahl Complet, med utgångspunkt från Fribergs analysmodell. Resultat: Resultatet presenteras i fem teman: Att bli diagnostiserad med diabetes typ 2, vårdpersonalens bemötande och betydelse för livsstilsförändringar, förändrade kostvanor, motivationens betydelse för att genomföra livsstilsförändring samt känslor vid livsstilsförändringar. Dessa teman presenteras i resultat delen. Sammanfattning: Många patienter är i behov av stöd och motivation för att kunna genomgå livsstilsförändringar. Vårdpersonal behöver en ökad kunskap kring hur de ska kunna arbeta motivationsfrämjande och personcentrerat för att stödja patienter som behöver genomgå livsstilsförändringar vid diabetes typ 2. / Background: Diabetes type 2 is a chronic public health disease caused by the low absorption of insulin in the body tissue. Diabetes type 2 can bring many complications, both acute and late complications. There are many factors that increase the risk of the disease, for instance lifestyle factors. Physical inactivity and unhealthy food are examples of lifestyle factors that increase the risk of being affected by the disease. Aim: The aim with this literature review was to describe patients experiences of lifestyle changes when living with diabetes type 2. Method: Literature overview where ten scientific articles were analyzed from the databases PubMed and Cinahl Complet, based on Friberg's analysis model. Results: The results are presented in five themes: Being diagnosed with diabetes type 2, the treatment of the healthcare staff and the importance of lifestyle changes, changed dietary habits, the importance of motivation for implementing lifestyle changes and emotions during lifestyle changes. These themes are presented in the results section. Summary: Many patients are in need of support and motivation to be able to undergo lifestyle changes. Health care professionals need increased knowledge about how they could work in a motivational and person-centered way to support patients who need a lifestyle change in type 2 diabetes.

Bakgrund: Diabetes mellitus typ 2 (DMT2) är ett globalt växande kronisk sjukdom. Cirka 500 000 personer i Sverige lider av diabetes, varav 90 procent har diabetes typ 2. Förekomsten av DMT2 ökar bland personer som har immigrerat till Sverige, vilket bedöms orsakas av en kombination av genetiska faktorer, livsstilsfaktorer och socioekonomiska omständigheter. För att effektivt hantera sjukdomen är det avgörande med noggrann egenvård, som inkluderar regelbunden självkontroll av blodsockernivåer, anpassad kost och fysisk aktivitet. Syfte: Syftet var att beskriva erfarenheter av egenvård hos immigrerade patienter som har diabetes typ 2. Metod: Kvalitativ litteraturöversikt baserad på 13 utvalda vetenskapliga artiklar som publicerades mellan 2003–2023. Litteratur söktes i databaserna CINAHL och Medline.  Artiklarna analyserades enligt Fribergs femstegsmodell. Resultat: En rad olika faktorer påverkade patienternas upplevelse av egenvård. Bristande kommunikation och språkfärdigheter samt otillräcklig kunskap om diabetes utgjorde stora utmaningar för patienterna när det gällde att förstå sin sjukdom. Patienterna hade olika uppfattningar om varför de drabbats av sjukdomen, ofta kopplade till kulturella och religiösa orsaker. Dessutom beskrivs frustration över vårdgivarnas bemötande och svårigheter för patienterna att bibehålla livsstilsförändringar. Slutsats: Patienternas uppfattning av DMT2 och egenvård spelar en avgörande roll. Det finns ett behov av ökad kunskap om kost, motion och medicinering för att möjliggöra kontinuerlig egenvård och förbättra hälsa. Socialt stöd underlättar acceptans av förändringar i livsstilen och främjar därmed egenvården. / Background: Diabetes mellitus type 2 (DMT2) is a globally growing chronic disease. Approximately 500 000 people in Sweden suffer from diabetes, of which 90 percent have DMT2. The prevalence of DMT2 is increasing among individuals who have immigrated to Sweden, which is assessed to be caused by a combination of genetic factors, lifestyle choices and social economic circumstances. To effectively manage DMT2, self-care is crucial, including regular monitoring of blood sugar levels, a tailored diet and physical activity. Aim: Describe self-care experiences among immigrant patients with diabetes type 2. Method: Qualitative literature review based on 13 selected articles published between 2003 and 2023. Literature was searched in the CINAHL and Medline databases. The articles were analysed using Friberg’s five-step model. Results: Several factors influenced a patient’s experience in managing their self-care. Lack of communication and language skills and insufficient knowledge about diabetes posed significant challenges for patients in understanding their illness. Patients held diverse perceptions regarding the causes for their diabetes, often linked to cultural and religious reasons. Furthermore, there was frustration regarding the healthcare providers’ attitudes and difficulties for patients in maintaining lifestyle changes. Conclusions: The patients’ perception of DMT2 and self-care plays a crucial role. There’s a need for increased knowledge about diet, exercise, and medication to enable continuous self-care and improve health. Social support facilitates the acceptance of lifestyle changes, thereby promoting self-care.