Phenomenology of Women’s Lived Experiences with Type-2 Diabetes in Rawalpindi, Pakistan

Abstract

Lived experiences with Type-2 diabetes are the result of three months of field work, which explore women's pre and post diagnosis experiences with diabetes and its management in Rawalpindi, Pakistan. During this study, I engaged with Type-2 diabetic women to know the reasons for delays in initial clinical diagnosis as well as adoption of the pathways for symptom diagnosis within the concept of intrapersonal and interpersonal factors. Further, the most critical phase of Type-2 diabetes is also discussed in this study, which refers to the post diagnosis psychosocial burden in terms of challenges women face due to diabetes and its management. This research study was carried out in two phases. The first phase involved in identifying and interact with Type-2 diabetes patients in the medical OPD of Cantonment General Hospital, where purposive sampling was used, and a total of 100 diabetic patients willingly filled the survey form, which helped to identify the type of diabetes and age of patients, as well as years of living with diabetes. For the second phase, a sample of 25 Type-2 diabetes patients have been selected through convenient and purposive sampling for an in-depth study. Hence, this in-depth research was done through a qualitative research method such as participant observation, in-depth interviews, fieldnotes and informal discussions were conducted to understand the problem under consideration. The findings of the study revealed that knowledge and awareness of diabetes symptoms have been low among patients, which is why patients had gone through with the illness for a long period and misinterpreted the condition according to beliefs and perceptions. This delay also occurred due to caregiving tasks and a lack of health literacy that forced women to ignore personal health and wait for illness to become severe. Hence, in situations of discussion and severity, women were taken up to a traditional healer for initial treatment by family members, and this delay in early seeking of diabetes developed co-morbidities, most commonly B.P. and stomach problems. This initial delay in diagnosis leads to the burden of both managing co-morbidities and diabetes A post phase was burdensome as it was not only about the psychosocial management of diabetes but also the emotional distress that women face in daily life. The fear of having diabetes related complications in the future, such as losing limbs, vision, fear of getting wounds and cuts, the stressful routine to manage diabetes with insulin and diet, the weight of external stigma, along with attending social gatherings. These all lead to emotional ups and downs that affect patients’ quality of life and effective diabetes management. However, in all these challenges, the relief came from family support, which helped and encouraged the women to adopt self-care behavior in order to overcome the difficulties. Women adhered to medication, monitoring their sugar level, diet, and physical activity to control glycemia. Together, these experiences demonstrate that the pathways from illness recognition to disease management are influenced not merely through clinical factors but also by deeply emotional and social forces. Through understanding the entire path from initial silence and facing these challenges and agency, this study advocates for more integrated gender-inclusive approaches that refer to care, support, and listening to women across the clinical boundaries.