What do Saudi Arabians, with type 2 diabetes mellitus, understand about the effects of

lifestyle on the progression and control of their condition?

The objectives of the Study:

The study is focused on answering the below questions:

a) What do patients with T2DM understand about the effects of lifestyle on their condition?

b) What lifestyle changes do people in Saudi Arabian make in order to help slow the

progression of their diabetes?

c) What kind of advice do people receive to help them control their diabetes?

3.0 Data Analysis

Following the data collection. Firstly, the researcher organised the data by gathering it in a text

sheet, for instance, converting it from audio records to text form. Secondly, the researcher read

through the transcripts several times to get a general idea about the data. For example, having a

sense of what do participant believe about T2DM? In this point, the researcher wrote a note

about the major themes. Thirdly, the researcher has organised the data by putting them in coding.

In this step, the researcher has manually sorted the themes for understanding the meaning of the

data. Fourthly, the researcher coded each transcript into five themes: 1- Psychological reaction at

the time of diagnosis, 2- Spiritual state toward T2DM, 3- Physical activity, 4- Compliance with

nutrition, 5- Sources of advices. Fifthly, presenting the ideas of the study and interpreting the

data.

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 Raw data

Prepare data for

analysis

Reading through
all data

Coding the data

Generate the
themes

Inerpret the
meaning of themes

Figure 1: process of analysing qualitative data

3.1 Analysis of the nominal data

3.1.1 Age

The study sought to find out the age of the participants. The results indicate that the majority of

the participants (70%) were aged between 45-54 (p 2, 3, 5, 6, 7, 8 and 10). 30% of the

participants were aged between 55 and 65 years (p1, 4 and 9) (table1).

Table 1: participant and Age bracket

Participant 1 2 3 4 5 6 7 8 9 10
Age 55-65 45-54 45-54 55-65 45-54 45-54 45-54 45-54 55-64 45-54

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3.1.2 Gender

The study sought to establish the gender of the participants. The findings indicate that 80% of the

participants were males (p 1, 2, 3, 4, 7, 8, 9 and 10) while 20% of the participants were females

(p5 and p6) as shown in table 2.

Table 2: Participant and Gender

Patient 1 2 3 4 5 6 7 8 9 10
Gender Male Male Male Male Female Female Male Male Male Male

3.1.3 Weight of the Participant

The study sought to establish the weight of the participants with respect to the weight changes of

the past year and current weigh. Some of the participants lost weight while others experienced

increase in weight.

Participant (p2, p3, p4, p5, p6, p7, p8, p9 and P10) had increased weight in the past year. The

findings as shown in table 3 indicate that 90 % of the participants had gained weight in the past

year. The researcher then calculated the BMI (Body Mass Index) of participants, taking into

account their height and weight. BMI of these participants shows that some of them are

overweight and some obese.

Table 3: Weight of the Participant

Patient 1 2 3 4 5 6 7 8 9 10
Weight Decrease Increase Increase Incre Incre changed Increas Increas Increas Increas
changes over ase ase e e e e
past year
Patient 85 78 102 68 90 65 73 73 80 68

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weight in Kg

Patient 170 165 180 165 160 162 162 163 160 158
height in Cm
Patients’ 29.4 28.7 31.5 25.0 35.2 24.8 27.8 27.5 31.2 27.2
BMI (Overweight) (Overwei (Obesity) (Over (Obe (Norma (Over (Over (Obesit (Over
ght) weigh sity) l weight weight y) weight
t) Weight) ) ) )

3.2 Analysis of the Study Themes

3.2.1 Psychological reaction at the time of diagnosis:

Firstly, the researcher asked the participants about their first reactions when they were initially

diagnosed with T2DM.

Some of the participants (p3 and 10) were shocked at the time of knowing the diagnoses.’’ I was

unable to breathe when my doctor told me that I am a diabetic patient’’ (p3). Another participant

felt anger as participant four stated ‘’I was very angry and I couldn’t speak a single word’’.

Another participant found it difficult. ‘’that moment when I diagnosed with T2DM was the

hardest moment in my life’’ (p6).

Other Participants (p2 and 8) showed that they understood and accepted the diseases. Participant

two said’’ I was expecting that due to my unhealthy lifestyle’’. ‘’There is no need to fear, I know

many people with T2DM who live their lives normally’’ (p8). Another participant found it

reassuring that he was diagnosed early on. ‘’I am lucky as they detected my disease in early

stage’’(p9).

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3.2.2 Spiritual State:

In Saudi Arabia, most of the residents are Muslims and they put a lot of faith to Allah, so most of

the participant’s sought comfort and acceptance because they had this faith.

Religious effect toward medicine: ‘’treatments are just reasons to get better but without help of

Allah you will never get better’’ (p9). ‘’the medicine has a positive effect if it is linked to the faith

of Allah’’(p3).

Religious effect on diseases: ‘’Allah has chosen this for me and whatever it happens to me it is

from Allah’’ (p6). Another Participant said ‘’As long as I maintain five prayers a day, Allah will

save me ‘’ (p2). From another Participant ‘’Allah will help me, nothing else can do’’ (p7).

Research shows, that the spiritual state has given most of the participant hope toward T2DM as

they belief that with help of Allah, they will be able to manage their condition. They believe that

having T2DM will allow Allah to forgive and reward them. They also believe that Allah is the

one who decides their fate. Therefore, their worries are decreased due to them being a believer

and having faith in Allah. In addition, the faith of the most participants made them more likely to

self-manage their diabetes and to seek ways to improve their control of their blood sugars level.

Only participant seven had a negative response as he beliefs that Allah will help him in his

disease and it does not matter if he changes his attitude or not; we might refer to this as a

fatalistic approach to health

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3.2.3 Physical Activity

The study sought to find out the effect of physical activity done by the participants as a way of

controlling their health and more so their body weight.

Participants who had unscheduled physical activities

Some of the participants engaged in random physical activities without adhering to any schedule.

Participants (p1, p3, p4, p5, p6 and7) undertook in physical exercises that were not prescheduled.

One participant stated’’ walking sometime in the morning makes me feel relaxed’’ (p3). The

participants further indicated that work and lack of time were the main barriers for them to

participate in the physical activities.’’ to be honest with you I don’t have time for exercises as I

am a teacher and I am busy preparing my lessons’’ (p4).In addition, some participants had some

activities but had no place to do the exercises for example, ‘’If we have walking area near our

house, I will be able to walk on daily basis’’(p1). Another participants indicated that they had

physical activities but they were tired could not participate in the exercise as much as they should

either due to physical limitations or to distractions such as the housework. ‘’.I walk, but I feel

pain in my Knees at night" (p7). ‘’I do exercise indoor which make me released but I am always

busy of growing my 3 children’s’’ (p6).

Participants who had scheduled physical activities

Some of the participants had organised exercises. Participants (p8, p9 and p10) had organised an

exercising schedule. The participants had a specific schedule and time frame for participating in

physical activities. ‘’walking is helpful’’(p10). Another mentions other activity like swimming

and riding a bicycle. ‘’Regular swimming makes me active’’ (p9).’’Riding a bicycle in early

morning makes me more comfortable’’ (p8).

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3.3.3 Compliance with nutrition

The participants have made an effort to change their eating habits. Participant (p1, p2, p8, p9)

had a good appetite of eating boiled foods like eggs and green vegetables instead of unhealthy

food. ‘’boiled eggs have many benefits’’(p9). Additionally, they mentioned that eating brown

bread is better than white bread, rice and pasta. One specifically said’ ’I feel better when I eat

food with low carbohydrate’’ (p8). In Addition, the data further indicates that some participant

stop eating their favourite food for example, ’’ I love eating chocolates, but I stopped eating

them a while ago ’’ (p1).

Another participants like participant (p3, p4 and p10) mentioned that consuming fresh juices

were helpful. ‘’fresh juices are healthy’’(p3). I avoid drinking coffee and tea and replacing them

with fresh juices’’ (p10).

Participant had not committed to following this eating habit as they were sometimes compelled

by friends and family members to eat unhealthy food like Saudi rice and chicken.’’ What can I

do with my friends we get together weekly, as we cook Saudi Kabsa’’ (p3). “I’m always

frustrated by my cultural habit which makes me eat unhealthy foods, again am always tempted

to take the restaurant foods which are not good at all” (p2).

3.3.4 Sources of advices.

The participants indicated that they had different advice that was aimed at helping them manage

T2DM.

Most of the participants (p1, p2, p3, p4, p7, p8, p9p10) have stated that they got

information from their primary physician, dietician, ophthalmologist and nurses about the

importance of healthy life. ‘’I am always advised by my doctor to do physical activities’’ (p8). In

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addition, the findings indicate that some of them are being told about the risk of complication as

one said ‘’my doctor told me if I couldn’t manage my diabetes, the complications could be

getting a renal failure’’(p10). In addition, participant who visited a dietitian said ‘’when I visited

a dietician he told me the balance and distribution of meals a day helps maintain the blood sugar

rate’’ (p1). Another old participant who had retina problem in his left eye said that’

’ophthalmologist advised me to maintain normal sugar rate to prevent vision loss’’ (p4). And the

nurses played an important role in helping to educate the participants on how to have a healthy

life. ’’ the nurse told me I should avoid fatty food to decrease my weight as I am at risk to get

obese’'(p3).

Some of the participants heard from their friend that the restriction on diet is good for their

condition.’’ I heard from an old friend who is a diabetic patient that restriction on diet is the best

way to overcome the diabetes’’ (p5). This participant has a privilege of having informed friends,

that friend has advised her accordingly.