Making sense of blood glucose data and self-management in individuals with type 2 diabetes mellitus: A qualitative study.

AIMS AND OBJECTIVES: To describe individuals with type 2 diabetes mellitus sensemaking of blood glucose data and other influences impacting self-management behavior. BACKGROUND: Type 2 diabetes mellitus prevalence is increasing globally. Adherence to effective diabetes self-management regimens is an ongoing health care challenge. Examining individuals' sensemaking processes can advance staff knowledge of and improve diabetes self-management behavior. DESIGN: A qualitative exploratory design examining how individuals make sense of blood glucose data and symptoms, and the influence on self-management decisions. METHODS: Sixteen one-on-one interviews with adults diagnosed with type 2 diabetes mellitus using a semi-structured interview guide were conducted March to May 2018. An inductive-deductive thematic analysis of data using the Sensemaking Framework for Chronic Disease Self-Management was utilized. The consolidated criteria for reporting qualitative research (COREQ) checklist was used in completing this paper. RESULTS: Three main themes described participants' type 2 diabetes mellitus sensemaking and influences on self-management decisions: classifying blood glucose data, building mental models, and making self-management decisions. Participants classified glucose levels based on prior personal experiences. Participants learned about diabetes from classes, personal experience, health information technology, and their social network. Seven participants expressed a need for periodic refreshing of diabetes knowledge. CONCLUSION: Individuals use self-monitored glucose values and/or HbA1C values to evaluate glucose control. When using glucose values, they analyze the context in which the value was obtained through the lens of personal parameters and expectations. Understanding how individuals make sense of glycemic data and influences on diabetes self-management behavior with periodic reassessment of this understanding can guide the healthcare team in optimizing collaborative individualized care plans. RELEVANCE TO CLINICAL PRACTICE: Nurses must assess sensemaking processes in self-management decisions. Periodic "refresher" diabetes education may be needed for individuals with type 2 diabetes mellitus.