The diabetes does not hurt, it is not felt, but it is here!

Metaphors from old people with type 2 diabetes in Portugal

Abstract

In Portugal more than a quarter of the population aged between 60 and 79 years old has type 2 diabetes mellitus. Therapeutic recommendations request patients’ self-management, since changes in lifestyles are involved. However, just around 20% of the patients are outstanding self-managers. Self-management is associated to beliefs, and metaphors are mechanisms that reflect the beliefs used by individuals to understand and take action. This study aims to analyse metaphors of type 2 older (≥ 65 years) diabetics, about “what is diabetes” (identity; causes; timeline and consequences), which is relevant for clinical practice. This qualitative and exploratory study uses the cognitive metaphor theory to uncover participants’ metaphors through semi-structured interviews. It comprises 17 participants that reported 84 metaphors. The interviews were submitted to content analysis. Main findings show that: identity is described by “illness that does not hurt, it is not felt, but it is here”; causes involve “I don’t know” and “I inherited it”; timeline and consequences portrayed as “slowly it destroys us”. These metaphors suggest that the old-aged type 2 diabetics experience the illness as something “mysterious”, which will most probably difficult their self-management.