Living with Diabetes: Personal Interviews with Pakistani Women in Norway
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The prevalence of Type 2 diabetes (T2D) among Pakistani women in Norway is remarkably high. This study aims to assess how they live with the disease and their response to lifestyle and medical information. 120 Pakistani women living in Norway (mean age: 55.7 years) were personally interviewed about their T2D using a structured questionnaire (response rate: 95%). The participants were first-generation immigrants (mean residence time: 28.7 years) of whom 27% were illiterates. Poor health was reported by one-third, and 71% had developed macrovascular comorbidities. A majority reported physical inactivity and an unhealthy diet included religious fasting. One-third was not able to self-measure their blood glucose. There was a great variation in antidiabetic drug regimens and one-fourth had to use insulin in addition to tablets. Pakistani women in Norway showed suboptimal control of their T2D in terms of lifestyle habits, comorbidities and drug use. Low literacy and cultural factors seem to challenge adherence to lifestyle and medical information.
KeywordsAdherence Diabetes Immigrants Norway Ramadan fasting
A grant was received from the Norwegian Pharmaceutical Society and used to fund gift cards to the women who participated in the study. We would also like to thank all key representatives who gave us permission to recruit participants at their premises and to all the Pakistani women who participated in the study.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
The Regional Committee for Medical and Health Research Ethics was contacted about the study. Approval was considered not required. The study protocol was referred to The Norwegian Social Science Data Services to be reviewed and the study was thereafter approved by them.
Informed consent was obtained from all individual participants included in the study.
- 1.Statistics Norway. Immigrants and immigrants’ descendents (in Norwegian). https://www.ssb.no/befolkning/statistikker/innvbef (2017). Accessed 10 Mar 2017
- 2.Oslo Municipality. Population background (in Norwegian). https://www.oslo.kommune.no/politikk-og-administrasjon/statistikk/befolkning/landbakgrunn/ (2016). Accessed 13 Dec 2016.
- 3.Jenum AK, Diep LM, Holmboe-Ottesen G, Holme IM, Kumar BN, Birkeland KI. Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians—the association with adiposity is strongest for ethnic minority women. BMC Public Health. 2012;12:150.CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Tran AT, Diep LM, Cooper JG, Claudi T, Straand J, Birkeland K, Ingskog W, Jenum AK. Quality of care for patients with type 2 diabetes in general practice according to patients’ ethnic background: a cross-sectional study from Oslo, Norway. BMC Health Serv Res. 2010;10:145.CrossRefPubMedPubMedCentralGoogle Scholar
- 7.The Norwegian Health Directorate. National proffesional guidelines for diabetes (In Norwegian). (2016). https://helsedirektoratet.no/Retningslinjer/Diabetes.pdf Accessed 17 Dec 2016.
- 8.Ryden L, Grant PJ, Anker SD, Xuereb RG, et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the task force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J. 2013;34:3035–87.CrossRefPubMedGoogle Scholar
- 9.Holmboe-Ottesen G, Wandel M. Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe. Food Nutr Res 2012; 56.Google Scholar
- 10.World Health Organization. Adherence to long-term therapies: evidence for action. http://www.who.int/chp/knowledge/publications/adherence_report/en/ (2003). Accessed 17 Dec 2016.
- 16.Abuelmagd W, Håkonsen H, Toverud EL. Experiences of Norwegian General Practitioners and Pharmacists following their contact with Ethnic Minority Patients. Paper presented at the Nordic Social Pharmacy and Health Services Research Conference, University of Gothenburg, The Sahlgrenska Academy, Sweden. 2013.Google Scholar
- 18.Bajaj S, Jawad F, Islam N, Mahtab H, Bhattarai J, Shrestha D, Wijeyaratne C, Muthukuda DT, Widanage NW, Aye TT, Aung MW, Kalra B, Anjana RM, Sreedevi A, Verma K. South Asian women with diabetes: psychosocial challenges and management: consensus statement. Indian J Endocrinol Metab. 2013;17:548–62.CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Statistics Norway. Population’s level of education. http://ssb.no/en/utdanning/statistikker/utniv (2016). Accessed 14 Dec 2016.
- 23.Kotseva K, De Bacquer D, De Backer G, Ryden L, Jennings C, Gyberg V, Abreu A, Aguiar C, Conde AC, Davletov K, Dilic M, Dolzhenko M, Gaita D, Georgiev B, Gotcheva N, Lalic N, Laucevicius A, Lovic D, Mancas S, Milicic D, Oganov R, Pajak A, Pogosova N, Reiner Z, Vulic D, Wood D, The Euroaspire Investigators. Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions. Eur J. Prev Cardiol. 2016;16:2007–18.CrossRefGoogle Scholar
- 27.Salti I, Benard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet C, Jabbar A. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care. 2004;27:2306–11.CrossRefPubMedGoogle Scholar