Support person involvement in dietary self-management for diabetes: Perspectives from veterans and their loved ones

Diabetes self-management often involves dietary modifications, which can be helped or hindered by family and friends. However, limited studies explore how people with diabetes and their support networks interact around dietary self-management. The purpose of this study was to examine interpersonal dynamics of diet and eating-related diabetes self-management, using interviews with Veterans and their support people. We interviewed 13 Veterans with diabetes and, separately, 15 of their support people. Interviews focused on support received (Veteran) and provided (support person) for diet-related self-management. Using qualitative dyadic analysis of interview transcripts, we examined overlaps and contrasts in how pairs/trios perceived one another’s role in dietary self-management for diabetes. Most support people were Veteran’s spouses (n=8), and 9 pairs/trios lived together (64%). We identified 4 themes relating to the interpersonal dynamics of diet and eating behavior: mismatch between the support person’s and Veteran’s accounts of involvement; heightened attention to perceived poor food choices; support people’s perceived threshold for successful self-management; and women-led eating behavior change. Veterans and their support people do not always agree about the latter’s role in dietary self-management. Understanding interpersonal influences and gendered expectations for eating behaviors can reveal intervention points to improve diabetes management. • Managing diabetes often involves dietary changes that loved ones may help or hinder. • We examined interpersonal dynamics of diet-related diabetes self-management. • We compared accounts from Veterans with diabetes and their support person(s). • Dyadic approach found imbalance in how pairs/trios assess their eating behaviors. • Findings inform how loved ones can better support diabetes management.