Kleissl-Muir Sabine, Driscoll Andrea, Owen Alice, Zinn Caryn, Rasmussen Bodil
J Cardiovasc Nurs. 2024;39(5):E172-E178. doi: 10.1097/JCN.0000000000001025. Epub 2023 Aug 8.
Cardiac dysfunction in patients with diabetes, referred to as diabetic cardiomyopathy, is primarily precipitated by dysregulations in glucose and lipid metabolism. Diet and lifestyle changes are considered crucial for successful heart failure and diabetes management and are often difficult to achieve. Low-carbohydrate diets (LCDs) have gained popularity for the management of metabolic diseases. Although quantitative research in this field is evolving, little is known about the personal experience of patients with diabetic cardiomyopathy on specific diets. The aim of this qualitative study was to identify enablers and barriers of patients with diabetic cardiomyopathy who engage in an LCD. It further explored patients' perception of dietary education and dietary support received while in hospital.
Participants who previously consented to a 16-week LCD trial were invited to share their experiences. Nine patients agreed to be interviewed. Semistructured interviews and a focus group interview were conducted, which were transcribed verbatim. Data were analyzed by using the 6-step approach for thematic analysis. Four themes were identified: (1) nutrition literacy (2) disease-related health benefits, (3) balancing commitments, and (4) availability of resources and support.
Improvements in disease-related symptoms acted as strong enablers to engage in an LCD. Barriers such as access to resources and time constraints were identified. These challenges may be overcome with efficient communication and ongoing dietary support. More research exploring the experience of patients with diabetic cardiomyopathy on an LCD are warranted.
糖尿病患者的心脏功能障碍，即糖尿病性心肌病，主要由葡萄糖和脂质代谢失调引发。饮食和生活方式的改变被认为是成功管理心力衰竭和糖尿病的关键，但往往难以实现。低碳水化合物饮食（LCD）在代谢疾病管理中越来越受欢迎。尽管该领域的定量研究不断发展，但对于糖尿病性心肌病患者在特定饮食方面的个人经历知之甚少。这项定性研究的目的是确定参与低碳水化合物饮食的糖尿病性心肌病患者的促进因素和障碍。它还进一步探讨了患者对住院期间接受的饮食教育和饮食支持的看法。
邀请之前同意参加为期16周低碳水化合物饮食试验的参与者分享他们的经历。9名患者同意接受采访。进行了半结构化访谈和焦点小组访谈，并逐字转录。采用6步主题分析方法对数据进行分析。确定了四个主题：（1）营养素养，（2）疾病相关的健康益处，（3）平衡各项事务，以及（4）资源和支持的可用性。
疾病相关症状的改善是参与低碳水化合物饮食的有力促进因素。确定了诸如获取资源和时间限制等障碍。通过有效的沟通和持续的饮食支持，这些挑战可能会得到克服。有必要开展更多研究来探索糖尿病性心肌病患者在低碳水化合物饮食方面的经历。
