COVID-19 pandemic and the management of type-2 diabetes mellitus among women in Fiji: concerns and context specific interventions.

Abstract

Introduction: The COVID-19 preventive strategies had a profound impact on type-2 diabetes management, creating challenges for individuals who depended on routine in-person consultations with healthcare workers. Given that the pandemic did not affect diabetic women equally across countries worldwide, this research was conducted in Fiji to explore how women living with type-2 diabetes managed their condition during the COVID-19 pandemic.

Materials and methods: This study used a qualitative approach from a descriptive phenomenological lens. A total of 45 women with type-2 diabetes were purposively selected for in-depth interviews, as the study depended on participants ability to provide relevant information on the phenomenon being investigated. The data collection involved using a semi-structured interview guide with participants selected from different ethnic groups, ages, religions and settings to enhance data diversity. The data were analyzed using an inductive thematic analysis approach.

Results: The themes that emerged were the perceived impact of the COVID-19 pandemic on T2DM management, coping strategies and recommended interventions. The perceived impact of the COVID-19 pandemic on diabetes management included limited access to healthcare workers and diabetes supplies, canceled or postponed appointments, changes in physical activities, difficulty in maintaining standard diets and diabetes complications. The coping strategies identified were emotional eating, religious practices, family support and the use of herbal medications. Participants recommended the need for financial support, accessible specialized healthcare services, intensifying diabetes education, virtual clinics and providing door-to-door diabetes supplies in crises, like the COVID-19 pandemic.

Conclusion: The findings underscore the need for stakeholders to mitigate the pandemic's impact on women with type-2 diabetes by ensuring better access to healthcare services, providers, and essential supplies to improve disease management. To ensure continuity of care during emergency situations, policy makers and health managers should implement interventions including virtual clinics and home deliveries of diabetes supplies. Strengthening education on diabetes management can prevent complications by addressing behavioral and safety issues such as emotional eating and the unauthorized use of herbal medications.