Table 7 Self-management: overview of each subcategory including underlying clusters and illustrative quotes

Disease insight

The use of medical devices

Q21. (Facilitator) ''Yes, I have [medical devices]. I bought a blood pressure monitor during the pandemic to keep track of my own blood pressure. Because now and then you feel a bit odd and I thought this was a way to keep checking myself." (8_F_60_Sur)

Q22. "Periodic appointments for blood tests were cancelled (…). I’ve got my own blood glucose meter; that's how I kept checking my values. For me it wasn’t a problem." (10_F_40_Sur)

Diseases in the family

Q23. (Facilitator) ''Yes, many of our relatives have diabetes. That’s why I’m conscious of the dangers of diabetes and the reason why I do my best to keep my sugar levels under control." (9_F_44_Tur)

The use of alternative medicine

Q24. (Barrier) ''[Yes, I tried some alternative medicine during the pandemic.] A type of dried fruit from Turkey. You have to cook it and then drink half a glass every day. I tried it but I don't know if it helped because I can't check myself. I haven't got a device to measure blood sugar. I've tried various things. Yes, grapefruit, there's no sugar in that either." (6_F_53_Tur)

Medication adherence

Q25. (Barrier) ''Being at home I do have periods when I forget. Every day is almost the same, so you can’t remember and start to wonder: Did I or didn’t I take it? There were actually days when I thought, ‘I'm not going to take another one because of side effects’." (3_M_42_Mor)

Lifestyle

Diabetes regulation

Q26. (Barrier) ''Guaranteed my sugar has gone up. You’re not getting any exercise. [You had] nowhere to go because everything was closed. I am also a stress eater, so I ate sugary things. It made me feel bad, no exercise, unhealthy food and a lot of stress. You don't get out of the house. I was tired all the time." (3_M_42_Mor)

Q27. (Barrier) ''I didn't go out for quite a while, at least three or four months. You just lie on the bed, eat, sometimes eat sugary things and hardly move." (5_M_50_Tur)

Q28. (Facilitator) ''My blood sugar is stable. It's not like it’s varying wildly. I receive timely warnings from my healthcare provider.'' (1_F_59_Sur)

Physical activity and diet

Q29. (Facilitator) ''Yes, when I had to work I went out every day. Or I was busy in my garden. I like to keep busy. Or I'm doing some painting. I'm always busy with something. No, every day was not the same for me during the COVID-19 period." (4_M_54_Sur)

Social support

Q30. (Facilitator) ''I tried to exercise, also because of my kids. They think a lot about me. They said to me, ‘Dad, please don't get, you know, like, Dad, please don't have soft drinks, don't have sugar, et cetera. We also bought fewer crisps during the pandemic. My kids said, ‘Dad, just stop for a while’. It's also important that your kids are in on it, because if your children participate the whole family does too." (7_M_50_Tur)

Q31. (Facilitator) ''My two sisters-in-law in particular are really trying to help me. If I eat something unhealthy, they tell me. They also call me to ask how I am doing. Sometimes when I tell them I have a headache, they tell me to pay more attention to my disease. I am grateful. They are good people." (9_F_44_Tur)

Self-confidence to control diabetes

Q32. (Facilitator) ''Yeah, just believe in yourself. I have my family, my friends, and very good colleagues. And I walk a lot at work. Okay, they say that’s not the same as exercising, but I walk 18,000 steps at work." (4_M_54_Sur)

Religion

Q33. (Facilitator) ''For example, when fasting during Ramadan I can stop myself eating until 11 o'clock in the evening, no real problem. But outside of Ramadan, if I'm not fasting I can't stop myself if I haven't eaten for a few hours. Faith gives me strength.” (9_F_44_Tur)