Publication:

Exploring the pathway from recognising symptoms to receiving a type 2 diagnosis among adults: a grounded theory study

Background The rising incidence of type 2 diabetes in Zimbabwe is linked to notable delays in diagnosis after symptoms emerge. Early detection, even before symptoms appear, is vital for clinical, social, and public health purposes. Although epidemiological data indicate an increase in cases, little is known about how patients perceive and respond to initial signs of diabetes. Gaining insight into this pre-diagnosis phase is essential for developing strategies to promote earlier detection and better engagement with healthcare services. This study examined the pathway from symptom recognition to a diagnosis of type 2 diabetes.

Methods The study was guided by a constructivist grounded theory approach. Twenty-eight semi-structured interviews were conducted with individuals diagnosed with type 2 diabetes at selected community pharmacies in Harare.

Results A theoretical category, ‘learning I have diabetes,’ emerged from the data analysis. ‘Learning I have diabetes’ is a non-linear process marked by interconnected milestones, such as recognizing symptoms, seeking information, health-seeking, experiencing negative emotions, denying the diagnosis, and ultimately accepting it.  The theoretical category outlines the social processes, from recognizing bodily changes and investigating behaviours to diagnosing type 2 diabetes.

Conclusions The process from recognising symptoms to receiving a type 2 diabetes diagnosis is intricate and not straightforward. It is influenced by psychological, socio-cultural, economic, and relational factors that affect health-seeking behaviours. This study indicates that culturally tailored awareness campaigns, enhanced primary care screening, and targeted information sharing can promote earlier diagnosis and help prevent diabetes-related complications.