Background To determine the views and experiences of people with Type 2 diabetes (T2DM) in relation to their diabetes self-management and to understand what additional support is required to support lifestyle changes.

Methods A qualitative study using semi-structured face-to-face and audio/telephone interviews. All interviews were audio-recorded, transcribed verbatim and analysed using a thematic approach. Seventeen people with newly diagnosed T2DM (less than 3 years of diagnosis) were recruited from a primary care clinic in the southern region of Malaysia (Johor Bahru).

Results Qualitative analysis revealed three major barriers to diabetes self-management: (i) psychological issues, e.g. depression and anxiety, such as feeling sad about the diagnosis and worried about the future; (ii) social factors e.g. shame and stigma of T2DM, feeling ashamed have diabetes at a young age and being different from peers ; (iii) perceived barriers e.g. environment and culture, such as ineffective support from healthcare providers, beliefs and use of herbal medicine, and the importance of eating rice and feast culture. Facilitators of diabetes self-management included greater perceived self-efficacy such as being disciplined about eating well, good support from immediate family members and religiosity.

Conclusion This study represents novel findings describing barriers and facilitators of effective T2DM self-management in Malaysia. It identifies specific cultural factors that are unique to the Malaysian population that have not been reported in western studies. If diabetes self-management education is to meet people’s needs within this region factors such as these need to be considered when developing new T2DM education programmes.