title: My voice: a grounded theory analysis of the lived experience of type 2 diabetes in adolescence.
abstract: OBJECTIVE
  The aims of this study were to (1) describe the lived experiences of youth with type 2 diabetes from the perspectives of youth, their primary caregivers and healthcare professionals; (2) explore the barriers and facilitators to adopting lifestyle approaches for diabetes self-management; and (3) generate a relevant grounded theory.
  
  
  METHODS
  This qualitative study was based on a grounded theory framework and consisted of interviews and focus groups with youth with type 2 diabetes (n=8), their primary caregivers (n=6) and healthcare professionals (n=8). Youth and their primary caregivers were purposely selected to represent extremes of successful self-management through lifestyle therapy. Focus groups were held with healthcare professionals (allied health [n=5]; pediatric endocrinologists [n=3]) in an effort to triangulate responses with youth and their primary caregivers.
  
  
  RESULTS
  Youth with type 2 diabetes, their primary caregivers and their healthcare professionals described supportive relationships as being important determinants of adopting healthful-living self-management behaviours. All 3 groups also recognized that social determinants of health (i.e. food insecurity, poverty) were significant barriers to adopting healthful living behaviours for families with youth who have type 2 diabetes. Healthcare professionals recognized that the barriers to self-management were different for youth with type 2 diabetes than for youth with type 1 diabetes and felt that families would benefit from a clinic dedicated to meet their unique needs.
  
  
  CONCLUSIONS
  Supportive relationships and social determinants of health are perceived as being significant determinants of the adoption of healthful behaviours by youth with type 2 diabetes and should be considered in clinical management and future therapeutic trials.
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada. Electronic address: jprotudjer@mich.ca.
authors.forename: Jennifer L P
authors.initials: JL
authors.lastname: Protudjer
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada.
authors.forename: Jacquelyn
authors.initials: J
authors.lastname: Dumontet
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada; Department of Pediatrics, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: McGavock
mesh_terms: D000293:Adolescent; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000523:psychology*; D017144:Focus Groups; D066296:Grounded Theory; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D012648:Self Care / Q000379:methods / Q000523:psychology*; D012944:Social Support
keywords: adolescence; diabète de type 2; qualitative; type 2 diabetes