Chapter One: Literature Review

1.1 Introduction

The worldwide prevalence of type 2 diabetes is skyrocketing alarmingly to epidemic proportions. According to King, Aubert and Herman (1998), in the year 2000 there were 150 million people with type 2 diabetes worldwide, and this number is expected to double by 2025. This explosive increase in type 2 diabetes prevalence is also associated with a significant increase in morbidity and mortality. (Dankner, Abdul-Ghani, Gerber, Chetit, Wainstein and Raz, 2007). This global increase in diabetes will occur because of population ageing and growth, and because of increasing trends towards obesity, unhealthy diets and sedentary lifestyles. Worldwide, according to the WHO Diabetes Action Now
Also highlighted by Frandsen et al (2002) was that diabetes therapy should impose minimal lifestyle restrictions, so as to encourage compliance and maximise glycaemic control.
It can be seen from the literature that lack of dietary knowledge and specific educational intervention is seen to be a major barrier to patient’s adherence to a healthful diet. Much educational advice offered to patients focuses on medication management to optimise blood glucose control; however more emphasis is necessary to motivate and sustain people with diabetes to adopt appropriate behaviour.

1.3 Family and health service support

The level of family and social support people receive has significant influence on their diabetes self-management practices. (Delamater, Jacobsen, Anderson, Cox, Fischer, Lustman, Rubin and Wysocki (2001). Through reviewing current literature it is clear that support from immediate and extended family with regard to healthy eating, and adequate support and communication with health service providers can hugely impact on dietary modification in diabetes.
Wellard, Rennie and King (2008) in a qualitative study, explored participants’ perceptions of barriers and issues regarding their diabetes care. (n=4). Four predominant themes identified were (i) community based services, (ii) family relationships, (iii) food as a social connector and (v) strategies that might help others. Spousal support was