Remission of type 2 diabetes: Perspectives of dietitians in Kuwait

• Published in: PloS one 2022-10, Vol.17 (10), p.e0276679-e0276679
• Main Authors: Alsaeed, Dalal, Guess, Nicola, Al Ozairi, Ebaa
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Body weight loss; Complications and side effects; Cookery for diabetics; Cultural factors; Data analysis; Data collection; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diet; Dietitians; Drug therapy; Focus groups; Gastrointestinal surgery; Grounded theory; Intervention; Lifestyles; Medicine and Health Sciences; Methods; Motivation; Nutrition research; Obesity; Overweight; Patient outcomes; People and Places; Prevention; Regression (Disease); Remission; Remission (Medicine); Risk factors; Surveys; Tertiary; Type 2 diabetes; Weight control; Weight loss
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0276679

Although many dietary and lifestyle interventions have been proposed, the concept of total dietary replacement (TDR) to achieve remission of type 2 diabetes in the Gulf region is new. With the high levels of obesity and type 2 diabetes in the region, offering TDR to patients for weight loss and remission of type 2 diabetes would assist in achieving health outcomes. The aim of the current study was to explore and understand remission of type 2 diabetes and TDR from the perspectives of dietitians to identify challenges and recommend solutions for implementation in Kuwait. A qualitative approach utilizing focus groups was chosen to explore the topic. Purposive sampling was used to gain experiences from a diverse sample across primary, secondary, and tertiary specialized diabetes centers. Discussions were audio-recorded and transcribed verbatim. Grounded theory using an iterative approach was applied to analyze the data. Three focus groups with a total of 17 participants achieved data saturation. The sample was varied in terms of workplace and years of experience. The three emerging themes were motivation to use the TDR approach, perceived challenges of TDR, and suggestions to improve and adapt approaches for Kuwait. Dietitians reported that remission of type 2 diabetes is a great motivator for patients to undergo TDR, although various factors were identified that may affect uptake including age, level of education, and social and cultural environment. By understanding dietitians’ perspectives, it has provided insight on views regarding the implementation of TDR to achieve remission in Kuwait and how best to tailor approaches by focusing on patient support needs and adopting a flexible approach.