Barriers and factors influencing how adults with type 2 diabetes perceive their risk of developing diabetes-related complications: a qualitative study

Background: Delayed diagnosis and poor management of type 2 diabetes can lead to severe acute and long-term complications, such as early death or disability. Research evidence has shown that without consistent and effective self-management practices, individuals with type 2 diabetes face a higher risk of avoidable complications. These self-management practices are mainly influenced by individuals’ perceptions of the risks linked to diabetes complications. Due to poor self-management practices particularly in Sub-Saharan Africa, it is crucial to identify the barriers and enablers that shape patients’ perceptions of their risk of developing complications. Methods: Twenty-three individuals with type 2 diabetes were purposively and theoretically sampled from purposively selected community pharmacies in Harare, Zimbabwe, between October 2023 and January 2024 and participated in semi-structured interviews. Results: The analysis of the data revealed that participants perceived risk of complications differently: some perceived a higher risk, while others perceived a lower risk, based on the meanings they ascribed to living with type 2 diabetes. Facilitators to perception of risks of complications were: (i) having personal risk experiences; (ii) information-seeking; and (iii) engaging in health-seeking behaviours. In contrast, barriers to perception of risks of complications were: (i) holding cultural or religious beliefs; (ii) being in denial about the illness; and (iii) lacking knowledge about diabetes. Conclusions: This study explored the factors shaping patients’ perceptions of risks for developing diabetes-related complications. It offers important insights into risk perception research in resource-constrained environments and assists healthcare providers and policymakers in developing strategies to support those at higher risk of such complications.