Abstract
Background: Type 2 diabetes mellitus (T2DM) is a major global and LMIC health challenge with profound psychosocial and health-system consequences. Qualitative research explains how patients interpret and live with T2DM, but findings are dispersed across settings.
Objective: To systematically review and meta-synthesize qualitative evidence on adults lived experiences of T2DM, highlighting common themes and LMIC-specific constraints.
Methods: We conducted a qualitative systematic review and thematic meta-synthesis. We searched PubMed/MEDLINE, CINAHL, Scopus, Web of Science and Google Scholar (January 2005–October 2025) for English-language qualitative studies involving adults with T2DM. Study quality was appraised using the CASP checklist. Findings were synthesised using inductive coding and thematic synthesis informed by Braun and Clarke.
Results: Twenty-five studies met inclusion criteria. Seven analytical themes were generated: (1) emotional and psychological impact; (2) cultural beliefs, knowledge and misconceptions; (3) social support, stigma and relationships; (4) physical and functional burden; (5) self-management challenges and coping strategies; (6) financial constraints; and (7) healthcare system experiences. Across contexts, fear of complications, treatment fatigue and difficulty sustaining lifestyle change were pervasive. In LMICs, these were amplified by cost, misinformation, limited access to monitoring, and system constraints such as overcrowding and stock-outs.
Conclusion: T2DM is lived as a long-term biopsychosocial condition. Diabetes services should incorporate psychosocial care, culturally tailored education, family-inclusive strategies, and health-system strengthening to reduce structural barriers in LMIC settings.