Background/Purpose: Constant self-management is important for type 2 diabetes patients to improve or maintain their quality of life, however it can become difficult and burdensome. The purpose of the current study is to qualitatively investigate the mechanisms of psychological adaption to a type 2 diabetes diagnosis and the factors affecting long-term healthy behaviors by referring to a theoretical framework of Posttraumatic Growth (PTG), that is, personal growth resulting from struggle with trauma.

Methods: A series of semi-structured interviews were conducted with adult patients (N = 10) who were diagnosed with type 2 diabetes over two years prior, maintaining an HbA1c of under 8% stable over 6-months, and showed a relatively higher level of PTG in a screening test using the extended version of the PTG Inventory.

Results: Interviews were analyzed by the Grounded Theory Approach. Three main mechanisms were identified. (1) Some were able to continue healthy behaviors because they experienced PTG as a result of single major life event that occurred prior to diagnosis. (2) Some were able to continue healthy behaviors because they experienced PTG as a result of a number of minor but stressful life events that occurred in succession prior to diagnosis. (3) Others were able to continue healthy behaviors because they experienced PTG directly as a result of the diagnosis of diabetes. Overall, patients included in the current analyses were not overly conscious of their diagnosis or treatment in their daily lives, and did not seem to struggle with identity conflicts relating to their diagnosis.

Conclusion: Current study identified three paths leading to healthy behaviors. Regardless of the triggering events, PTG experiences seem to transform cognitive processes and increase stress tolerance, resiliency, and perhaps purpose in life and a sense of identity, and thus enable them to maintain healthy behaviors. Future study should explore the paths among patients who have not experienced PTG.


A. Kayano: None. M. Yamazaki: None. K. Taku: None. R. Sakai: None. N. Higo: None. M. Asano: None. T. Hosokawa: None. M. Kawase: None. M. Fukui: Research Support; Self; Grant-in-Aid for Scientific Research (C), Ono Pharmaceutical Co., Ltd., AstraZeneca, Astellas Pharma US, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Kyowa Hakko Kirin Co., Ltd., Kissei Pharmaceutical Co., Ltd., MSD K.K., Novo Nordisk Foundation.

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