Diabetes in solitude: A mixed-methods exploration of glycemic control,emotional well-being,and practical challenges of self-management in single-living individuals with type 2 diabetes

Abstract

Living alone with type 2 diabetes poses unique challenges that may compromise self-management. This mixed-method study examined glycemic outcomes, emotional well-being, and self-care difficulties among 72 adults with type 2 diabetes in a primary care setting in Indonesia. Quantitative measures included glycated hemoglobin (HbA1c), fasting blood glucose, and self-reported anxiety, loneliness, fatigue, and sleep quality, while structured surveys and open-ended questions assessed self-care challenges. Results showed high rates of loneliness (69.4%), anxiety (69.4%), fatigue (66.7%), and poor sleep quality (63.9%), each significantly associated with suboptimal glycemic control (p < 0.05). Practical barriers included difficulties with meal planning, low motivation for physical activity, inconsistent medication adherence, and irregular glucose monitoring. Qualitative responses emphasized emotional distress, lack of support, and feelings of isolation as major obstacles. Findings highlight the need for multidisciplinary, socially oriented interventions to address both psychosocial and practical barriers in this vulnerable population.