Lived Experiences and Influencing Factors in Type 2 Diabetes Management Among Nepali Speaking Bhutanese Americans

Background Type 2 diabetes is a significant health concern among Nepali-speaking Bhutanese (NSB) individuals, a resettled refugee population in the U.S. However, limited research exists on the challenges and experiences of this group in managing their diabetes, particularly within a cultural context. Objective This study aims to understand the lived experiences of NSB patients self-managing type 2 diabetes and identify the barriers, facilitators, and recommendations for healthcare providers and community organizations. Methods This qualitative phenomenological study used semi-structured, in-person interviews with six NSB adults with type 2 diabetes in the Greater Harrisburg area of Pennsylvania (August–November 2024). A native Nepali-speaking researcher conducted the interviews to understand their lived experience self-managing their type 2 diabetes. Audio recordings were transcribed, translated, and analyzed using inductive thematic analysis in MAXQDA 24, with intercoder reliability of (κ = 0.76). Results Six Nepali-speaking Bhutanese adults (four females, two males; ages 45–75+) participated in this qualitative study. Most had no formal education (n=5), limited literacy, and minimal English proficiency. Five were unemployed and covered by Medicaid; one was employed with employer-based insurance. Participants had lived with type 2 diabetes for two to fifteen years. Five themes emerged: (1) participants described an emotional trajectory from fear and misinformation at diagnosis to gradual acceptance and self-efficacy; (2) multiple barriers—language, transportation, physical limitations, and competing responsibilities—hindered self-management, though culturally familiar practices and personal motivation facilitated adaptation; (3) trust in healthcare providers was fostered through education and nurse outreach but undermined by communication gaps, cultural disconnects, and inconsistent follow-up; (4) participants recommended culturally and linguistically tailored resources, simplified interpretation services, and user-friendly diabetes technologies; and (5) community organizations and religious/cultural spaces were identified as critical venues for outreach, education, and navigation support. Conclusion Despite significant barriers, NSB individuals demonstrate a strong commitment to diabetes self-management. Culturally and linguistically responsive care is essential to reduce disparities and improve outcomes in this underserved group.