{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T23:01:51Z","timestamp":1783119711573,"version":"3.54.6"},"reference-count":47,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Synergy Program Funding Scheme, La Trobe University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Type 2 diabetes (T2D) prevalence is rising worldwide. Despite numerous efforts to address the condition, many initiatives fall short due to limited consumer engagement. Involving people with lived experience in healthcare design is increasingly recognized as an effective strategy for improving diabetes management. Aim: To understand the unmet needs of people with T2D in self-managing their condition through the establishment of a Consumer Reference Group (CRG). Methods: The CRG was established using a standardized approach advised by Monash Partners, with specific terms of reference for consumer engagement. A face-to-face training workshop was conducted to develop consumers\u2019 capacity to co-design T2D interventions. Two focus groups were held to explore consumers\u2019 unmet needs and propose potential solutions. An inductive thematic analysis was performed. Results: Ten adults (three females\/seven males; 58\u201378 years old) with T2D participated. Four main themes emerged: (1) misinformation; (2) limited guidance; (3) challenges in self-management; and (4) gaps in prevention and screening. Participants reported difficulties in maintaining motivation, balancing T2D management with other life commitments, and addressing mental health concerns. They reported feeling misinformed and inadequately supported by healthcare professionals and diabetes organizations, often relying on conflicting sources of information. Participants from culturally and linguistically diverse (CALD) backgrounds noted a lack of tailored dietary information. Proposed solutions included better training for primary care providers, reinforcing the role of diabetes nurse educators, expanding mental health support, and collaborating with CALD communities to provide culturally appropriate dietary information. Conclusions: These insights are critical for developing consumer-driven interventions that are responsive to the real-world needs of people living with T2D.<\/jats:p>","DOI":"10.3390\/nu17071243","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T07:47:44Z","timestamp":1743580064000},"page":"1243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding the Unmet Needs of People Living with Type 2 Diabetes in Self-Managing Their Condition"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3397-8588","authenticated-orcid":false,"given":"Katerina","family":"Sarapis","sequence":"first","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8555-0463","authenticated-orcid":false,"given":"Yingting","family":"Cao","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"},{"name":"Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Abou Chakra","sequence":"additional","affiliation":[{"name":"School of Rural Health, Monash University, Clayton, VIC 3800, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Nunn","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Rathod","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Weber","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlyle","family":"Albuquerque","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryse","family":"Chapman","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Barr","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Gilfillan","sequence":"additional","affiliation":[{"name":"Endocrine Research, Eastern Clinical Research Unit, Eastern Health, Melbourne, VIC 3128, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9959-5750","authenticated-orcid":false,"given":"Helen","family":"Skouteris","sequence":"additional","affiliation":[{"name":"Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia"},{"name":"School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9923-4461","authenticated-orcid":false,"given":"Peter","family":"Brukner","sequence":"additional","affiliation":[{"name":"La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services & Sport, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Beauchamp","sequence":"additional","affiliation":[{"name":"School of Rural Health, Monash University, Clayton, VIC 3800, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3009-6675","authenticated-orcid":false,"given":"George","family":"Moschonis","sequence":"additional","affiliation":[{"name":"Discipline of Food, Nutrition and Dietetics, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia"},{"name":"La Trobe Institute for Sustainable Agriculture & Food (LISAF), La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1016\/S0140-6736(17)30058-2","article-title":"Type 2 diabetes","volume":"389","author":"Chatterjee","year":"2017","journal-title":"Lancet"},{"key":"ref_2","unstructured":"International Diabetes Federation (2024, December 20). IDF Diabetes Atlas, 10th Edition. Available online: https:\/\/www.diabetesatlas.org."},{"key":"ref_3","unstructured":"Australian Bureau of Statistics (2024, November 20). Diabetes. Canberra: ABS, Available online: https:\/\/www.abs.gov.au\/statistics\/health\/health-conditions-and-risks\/diabetes\/latest-release."},{"key":"ref_4","unstructured":"Australian Insitute of Health and Welfare (2024, November 20). Diabetes: Australian Facts, Available online: https:\/\/www.aihw.gov.au\/reports\/diabetes\/diabetes\/contents\/summary."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"766","DOI":"10.31128\/AJGP-11-20-5718","article-title":"Annual trends in diabetes screening and management in Australia: A secondary analysis of Medicare Benefits Schedule data","volume":"50","author":"Tijs","year":"2021","journal-title":"Aust. J. Gen. Pract."},{"key":"ref_6","first-page":"100240","article-title":"Prevalence, incidence and risk factors of diabetes in Australian adults aged \u2265 45 years: A cohort study using linked routinely-collected data","volume":"22","author":"Zhang","year":"2020","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref_7","unstructured":"Australian Government (2025, March 20). Commonwealth of Australia the National Obesity Strategy 2022\u20132032, Available online: https:\/\/www.health.gov.au\/resources\/publications\/national-obesity-strategy-2022-2032."},{"key":"ref_8","first-page":"15003","article-title":"Trends in incidence of total or type 2 diabetes: Systematic review","volume":"366","author":"Magliano","year":"2019","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S2213-8587(20)30402-2","article-title":"Trends in the incidence of diagnosed diabetes: A multicountry analysis of aggregate data from 22 million diagnoses in high-income and middle-income settings","volume":"9","author":"Magliano","year":"2021","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_10","unstructured":"(2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. Lancet, 402, 203\u2013234."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s00125-019-05039-w","article-title":"2019 update to: Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"63","author":"Buse","year":"2020","journal-title":"Diabetologia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1111\/hex.12640","article-title":"How to practice person-centred care: A conceptual framework","volume":"21","author":"Santana","year":"2018","journal-title":"Health Expect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1111\/jhn.13082","article-title":"Co-designing nutrition interventions with consumers: A scoping review","volume":"36","author":"Meloncelli","year":"2023","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.2337\/diaclin.33.1.32","article-title":"The diabetes attitudes, wishes and needs second study","volume":"33","author":"Funnell","year":"2015","journal-title":"Clin. Diabetes"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1111\/j.1464-5491.2005.01644.x","article-title":"Psychosocial problems and barriers to improved diabetes management: Results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study","volume":"22","author":"Peyrot","year":"2005","journal-title":"Diabet. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.diabres.2012.11.016","article-title":"Diabetes Attitudes Wishes and Needs 2 (DAWN2): A multinational, multi-stakeholder study of psychosocial issues in diabetes and person-centred diabetes care","volume":"99","author":"Peyrot","year":"2013","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.diabres.2019.02.025","article-title":"Work matters: Diabetes and worklife in the second diabetes attitudes, wishes and needs (DAWN2) study","volume":"150","author":"Cleal","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.diabet.2009.02.001","article-title":"How do patients with type 2 diabetes perceive their disease? Insights from the French DIABASIS survey","volume":"35","author":"Hochberg","year":"2009","journal-title":"Diabetes Metab. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1177\/1359105320980821","article-title":"Social support buffers the impacts of Diabetes distress on health-related quality of life among type 2 diabetic patients","volume":"27","author":"Onu","year":"2022","journal-title":"J. Health Psychol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Thi, D.K., Xuan, B.N., Le Duc, C., Gammeltoft, T., S\u00f8ndergaard, J., Meyrowitsch, D.W., Bygbjerg, I.C., and Nielsen, J. (2021). Unmet needs for social support and diabetes-related distress among people living with type 2 diabetes in Thai Binh, Vietnam: A cross-sectional study. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-11562-6"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20132019: Update From the GBD 2019 Study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","unstructured":"Buckley, A. (2007). Preventing Type 2 Diabetes in Culturally and Linguistically Diverse Communities in NSW, NSW Department of Health."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"313","DOI":"10.2337\/diacare.23.3.313","article-title":"The influence of treatment modality and ethnicity on attitudes in type 2 diabetes","volume":"23","author":"Fitzgerald","year":"2000","journal-title":"Diabetes Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1177\/0145721706290435","article-title":"A systematic review of research on culturally relevant issues for Hispanics with diabetes","volume":"32","author":"Caban","year":"2006","journal-title":"Diabetes Educ."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"285","DOI":"10.2174\/157339906777950606","article-title":"Barriers to achieving optimal glycemic control in a multi-ethnic society: A US focus","volume":"2","author":"Funnell","year":"2006","journal-title":"Curr. Diabetes Rev."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Jessup, R.L., Osborne, R.H., Buchbinder, R., and Beauchamp, A. (2018). Using co-design to develop interventions to address health literacy needs in a hospitalised population. BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-3801-7"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Haldane, V., Chuah, F.L.H., Srivastava, A., Singh, S.R., Koh, G.C.H., Seng, C.K., and Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0216112"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1136\/bmj.325.7375.1263","article-title":"Systematic review of involving patients in the planning and development of health care","volume":"325","author":"Crawford","year":"2002","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0168-8510(01)00214-7","article-title":"Consumer involvement in health research: A review and research agenda","volume":"61","author":"Boote","year":"2002","journal-title":"Health Policy"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1046\/j.1365-2753.2003.00376.x","article-title":"Seeking evidence from medical research consumers as part of the medical research process could improve the uptake of research evidence","volume":"9","author":"Whitstock","year":"2003","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_31","unstructured":"Monash Partners (2025, January 06). Establishing Consumer and Community Involvement Committees and Advisory Groups. Available online: https:\/\/monashpartners.org.au\/education-training-and-events\/cci\/module-5-establishing-consumer-and-community-involvement-committees-and-advisory-groups\/."},{"key":"ref_32","unstructured":"(2024, January 20). The Kids Research Institute Australia. Available online: https:\/\/www.thekids.org.au\/be-involved\/help-shape-our-research\/."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1111\/hex.13470","article-title":"Mapping definitions of co-production and co-design in health and social care: A systematic scoping review providing lessons for the future","volume":"25","author":"Masterson","year":"2022","journal-title":"Health Expect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1111\/hex.12888","article-title":"Frameworks for supporting patient and public involvement in research: Systematic review and co-design pilot","volume":"22","author":"Greenhalgh","year":"2019","journal-title":"Health Expect."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1525822X16639015","article-title":"How Many Focus Groups Are Enough? Building an Evidence Base for Nonprobability Sample Sizes","volume":"29","author":"Guest","year":"2016","journal-title":"Field Methods"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_37","unstructured":"(2024, August 01). Diabetes Australia. Available online: https:\/\/www.diabetesaustralia.com.au\/."},{"key":"ref_38","unstructured":"(2024, August 01). Diabetes Victoria. Available online: https:\/\/www.diabetesvic.org.au\/."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1016\/j.amepre.2019.02.005","article-title":"Team-Based Care to Improve Diabetes Management: A Community Guide Meta-analysis","volume":"57","author":"Levengood","year":"2019","journal-title":"Am. J. Prev. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s10903-023-01576-0","article-title":"Barriers and Enablers of Diabetes Self-Management Strategies Among Arabic-Speaking Immigrants Living with Type 2 Diabetes in High-Income Western countries\u2014A Systematic Review","volume":"26","author":"Althubyani","year":"2024","journal-title":"J. Immigr. Minor. Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/S2213-8587(24)00184-0","article-title":"A roadmap for integrating mental health and diabetes services","volume":"12","author":"Ismail","year":"2024","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_42","unstructured":"WHO (2024, October 15). Commercial Determinants of Health. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/commercial-determinants-of-health."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Pamungkas, R.A., Chamroonsawasdi, K., and Vatanasomboon, P. (2017). A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients. Behav. Sci., 7.","DOI":"10.20944\/preprints201705.0104.v1"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"225","DOI":"10.4239\/wjd.v6.i2.225","article-title":"Technology and diabetes self-management: An integrative review","volume":"6","author":"Hunt","year":"2015","journal-title":"World J. Diabetes"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.2337\/dc16-0346","article-title":"Do Mobile Phone Applications Improve Glycemic Control (HbA1c) in the Self-management of Diabetes? A Systematic Review, Meta-analysis, and GRADE of 14 Randomized Trials","volume":"39","author":"Hou","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s00125-019-05034-1","article-title":"Diabetes digital app technology: Benefits, challenges, and recommendations. A consensus report by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) Diabetes Technology Working Group","volume":"63","author":"Fleming","year":"2020","journal-title":"Diabetologia"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e025714","DOI":"10.1136\/bmjopen-2018-025714","article-title":"Impact of mobile health applications on self-management in patients with type 2 diabetes mellitus: Protocol of a systematic review","volume":"9","author":"Bene","year":"2019","journal-title":"BMJ Open"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/7\/1243\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:08:37Z","timestamp":1760029717000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/7\/1243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,2]]},"references-count":47,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["nu17071243"],"URL":"https:\/\/doi.org\/10.3390\/nu17071243","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,2]]}}}