Perceived Dietary Restrictions and Lifestyle Modification Challenges among Patients With Type 2 Diabetes Mellitus: A Qualitative Evaluation in Rural Mangaluru

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) demands extensive behavioral modifications, yet adherence to medicines is mediated by subjective perceptions. This study aims to qualitatively evaluate the non-clinical barriers, dietary distress, and coping mechanism among patients requiring diabetic care within rural community. Material &  Methods: An inductive, qualitative cross-sectional design using a phenomenology approach was conducted from August to September 2025 in rural Mangaluru, Karnataka. Participants were recruited via purposive sampling until thematic data saturation was achieved. Detailed narrative and open-ended data tracking focused on the functional domains of the validated Quality of Life in Diabetes (QOLID) framework, emphasizing on dietary tolerance and lifestyle modification domains. Results: The thematic analysis identified "Diet Advice Tolerance" as the primary source of concern among the study participants with regard to behavioral change. While clinical pharmacological adherence was perceived as a low-stress routine facilitated by extensive utilization of free primary health care system, modifying traditional eating habits introduced intense psychosocial distress, resulting in food-related isolation during local sociocultural and familial get-together. Conclusions: Chronic diabetes care in rural setting is hindered by the psychological demands of lifestyle modification rather than access to medication or financial constraints. Primary healthcare platforms must integrate culturally tailored nutritional counseling into standard of care, such as the Ayushman Bharat Arogyamandir framework, to support long-term behavioral change communication strategy.