Adapting to and Managing Diabetes

PURPOSE: To advance understanding of the lived experience of diabetes as described in published research and theses. Meta-analysis extends the analysis of individual research studies beyond individual experience to incorporate dominant system beliefs and health system ideologies. ORGANIZING FRAMEWORK: Curtin and Lubkin's (1990) conceptualization of the experience of chronic illness. SOURCES: Forty-three qualitative interpretive research reports in six computerized data bases 1980-1996 pertaining to the lived experience of diabetes and published in nursing, in the social sciences, and in allied health journals were used. METHODS: Meta-ethnography in which trustworthiness was achieved by using multiple researchers, identifying negative or disconfirming cases, and testing rival hypotheses FINDINGS: Balance is the determinant metaphor of the experience of diabetes. People learn to balance diabetes through their experience and experimentation with strategies for managing their illness. CONCLUSIONS: Learning to balance is a developmental process in which one learns to assume control of diabetes management. Support for such development requires that nurses know their clients as individuals and value the expertise they have gained in living with diabetes. Control of blood sugar levels within a prescribed range may be a goal established by professionals, but the goal of healthy balance determines a person's willingness to assume an active role in self-care.