The Intersection of Ethnocultural Identity and Glycemic Management: A Qualitative Synthesis of Dietary Constructions Among Individuals with Uncontrolled Diabetes in Asia

Background: Effective dietary control remains a core pillar of type 2 diabetes mellitus (T2DM) therapy; however, individual adherence is substantially regulated by deep-rooted sociocultural norms. Traditional Asian diets, familial expectations, and cognitive frameworks often conflict with Western-centric professional recommendations, resulting in metabolic susceptibility and poor glycemic measures. Objective: This meta-qualitative review and synthesis systematically assesses and integrates regional qualitative evidence regarding the ethnocultural identity and nutritional self-management practices of Asian individuals living with uncontrolled diabetes. Methodology: Systematic literature searches were executed across PubMed, Embase, PsycINFO, and CINAHL using strict eligibility criteria, focusing on main qualitative designs with raw participant quotations. Seven high-quality excellent studies from Nepal, Sri Lanka, China, Japan, Myanmar, and Indonesia were selected. The Critical Appraisal Skills Programme (CASP) checklist assessed methodological quality, while the GRADE-CERQual framework completed the evidence confidence profiling. Inductive thematic analysis and rigorous data extraction were done to guarantee a high level of conceptual synthesis. Results: Seven key themes were identified in the synthesis: (1) resistance to cultural nutrition centered on rice heritage; (2) misclassification of carbohydrates conflating starch and sweetness; (3) family and gender dynamics restricting personal food autonomy; (4) professional and workplace impacts affecting care during corporate obligations; (5) medical pluralism incorporating parallel herbal therapies; (6) social rejection viewed as communal dishonor; and (7) structural treatment compliance challenges. Conclusion: Dietary non-adherence in uncontrolled T2DM is a complex, family, and career-challenging choice rather than simple individual negligence. To maximize metabolic treatments, clinical teams must abandon strict, non-contextual dietary rules, as well as create flexible dietary guidelines, rooted in culture and respecting heritage principles.