Background South Asians in the UK have a 5-fold increased risk of Type 2 diabetes mellitus (T2DM), a much lower mean age at diagnosis and experience relatively higher diabetes-related morbidity and mortality compared to the general population. It is suggested that these premature adverse outcomes are due to deficits in knowledge, barriers to making lifestyle changes (i.e. diet, physical activity) and gender inequalities. We sought to understand barriers to making lifestyle changes in the self-management of T2DM among South Asian women to inform the development of public health initiatives to prevent or delay the incidence of adverse diabetes-related outcomes.

Methods In this qualitative study, first-generation South Asian women (aged 40–65 years) who had been diagnosed with T2DM in the last five years were recruited through community support groups. Semi-structured interviews were conducted using a topic guide and subjected to thematic analysis. The Brighton and Sussex Medical School Ethics Committee approved the study, and written informed consent was obtained from all participants.

Results Participants identified three broad themes as barriers to making lifestyle changes. First, personal factors included lack of knowledge about the causes and complications of T2DM, self-neglect due to cultural/social norms, tendency to prefer medication over lifestyle changes, psychological worries around the cultural symbolism of food and inadequate emotional support from family. Second, environmental factors included the negative impact of family dynamics and household practices, reluctance to engage in prescribed physical activity, lack of culturally appropriate community support, and cultural insensitivity among healthcare providers. Third, sociocultural factors included gender specific obligations of the traditional South Asian ‘wife’, and social pressures to prepare and consume energy-dense foods (rich in fats/carbohydrates/sugar) during festivals and gatherings.

Conclusion Women from South Asian backgrounds require considerable literacy about the causes, complications and self-management of T2DM and practical support from the family and healthcare providers to empower them to prevent or delay the incidence of adverse outcomes. These findings inform the development of an all-inclusive public health approach involving T2DM patients, their families, the wider community, and healthcare providers to tackle the misconceptions, socio-cultural constraints and negative attitudes.