A qualitative study of 13 people with pre-diabetes in Singapore found that major barriers to managing the condition include work stress, difficulty sustaining diet and exercise changes, high costs of healthy food, and feeling rushed during doctor visits. However, research shows that family support, caring healthcare providers, and fear of developing type 2 diabetes significantly help people stay motivated. According to Gram Research analysis, the study suggests that improving pre-diabetes care requires not just better screening programs, but also healthcare system reforms like shorter wait times and longer doctor appointments.
A new study from Singapore asked 13 people with pre-diabetes about their real-life experiences managing this condition. Researchers found that people struggle with making lasting diet and exercise changes, dealing with busy work schedules, and sometimes feeling like doctors don’t fully listen to them. But the study also found that support from family, caring healthcare providers, and fear of developing full diabetes can help people stay motivated. The findings suggest that Singapore’s healthcare system needs to make appointments faster, give doctors more time with patients, and create better programs to help people catch pre-diabetes early and manage it successfully.
Key Statistics
A qualitative study of 13 people with pre-diabetes in Singapore published in BMJ Open (2024) identified six major themes in patient experiences, with work-related time constraints and difficulty sustaining lifestyle changes emerging as the strongest personal barriers to managing the condition.
Research from Singapore’s primary care setting found that family support, feeling heard by healthcare providers, and fear of developing type 2 diabetes were the three strongest enablers helping people with pre-diabetes maintain lifestyle changes.
The study revealed that 5-10% of adults with pre-diabetes progress to type 2 diabetes annually, yet the research showed that healthcare system barriers like long wait times and clinician rotation significantly reduced people’s ability to access preventive care.
Among 13 pre-diabetes patients interviewed between August 2023 and February 2024, financial burden of healthy food, competing work priorities, and short medical consultations were identified as major structural obstacles to successful disease management.
The Quick Take
- What they studied: How people in Singapore experience being diagnosed with pre-diabetes and what helps or hurts them when trying to manage it
- Who participated: 13 adults living in Singapore who had been diagnosed with pre-diabetes, recruited from health clinics between August 2023 and February 2024
- Key finding: People face major obstacles like busy work schedules, difficulty changing eating habits, and high costs of healthy food, but family support and caring doctors help them stay on track
- What it means for you: If you have pre-diabetes, know that your struggles are common and shared by many others. Getting support from family and finding a doctor who listens can make a real difference in managing your condition and preventing it from becoming type 2 diabetes
The Research Details
Researchers conducted one-on-one interviews with 13 people living with pre-diabetes in Singapore between August 2023 and February 2024. They asked detailed questions about how people found out they had pre-diabetes, how it changed their daily lives, and what made managing it easier or harder. All interviews were recorded and written down word-for-word, then carefully analyzed to find common patterns and themes in people’s experiences.
This approach, called phenomenological research, focuses on understanding what life is actually like for people living with a condition, rather than just measuring numbers or testing treatments. The researchers looked for both the obstacles people faced (like time constraints and cost) and the things that helped them succeed (like family support and good doctors).
The study included people from Singapore’s diverse communities who spoke different local languages, making sure the research captured experiences across different cultural backgrounds.
Understanding how real people experience pre-diabetes diagnosis and care is crucial because it reveals gaps that numbers alone cannot show. When researchers listen to patients’ actual stories, they discover practical problems—like long wait times at clinics or doctors rushing through appointments—that affect whether people can successfully manage their condition. This type of research helps doctors and policymakers design better systems and programs that actually work for the people they serve.
This study provides valuable insights into patient experiences but has important limitations to understand. The sample size of 13 people is small, so findings may not represent all people with pre-diabetes in Singapore. The study was conducted in one healthcare system, which may differ from other settings. Because participants were recruited through clinics, the study may have missed people who avoid healthcare entirely. However, the detailed, in-depth interviews provide rich information about real-world challenges that larger studies often miss.
What the Results Show
The research identified six major themes in how people experience pre-diabetes. First, people discovered their pre-diabetes diagnosis in different ways—some found out while being treated for other health problems, while others sought screening on their own. Second, receiving a pre-diabetes diagnosis triggered strong emotional reactions including shock, worry about the future, and uncertainty about what it meant for their health.
Third, people described their lives before diagnosis as comfortable, often without realizing they were at risk because they didn’t have obvious symptoms. Fourth, after diagnosis, people tried to change their eating and exercise habits, though many also explored traditional or alternative therapies alongside medical advice. Fifth, managing pre-diabetes involved real challenges like sustaining lifestyle changes, dealing with work stress, and affording healthy food. Sixth, people had suggestions for improving care, including shorter wait times, more time with doctors, and better information about pre-diabetes.
The biggest obstacles people faced were personal (struggling to stick with diet and exercise changes), social (family eating habits and lack of time), financial (healthy food costs more), and healthcare-related (long waits, doctors changing frequently, rushed appointments). The strongest helpers were fear of developing type 2 diabetes, support from family and friends, and healthcare providers who truly listened and cared.
The study revealed that people often didn’t pursue health screening because they felt safer not knowing about potential health problems—a pattern researchers call ‘when not knowing felt safer.’ Many participants described trying to balance competing demands like work, family, and health management, with work often winning out. Some people integrated traditional or cultural approaches to health alongside medical recommendations. The research also showed that feeling heard and respected by healthcare providers was just as important as the medical advice itself.
According to Gram Research analysis, this study adds important detail to what we already know about pre-diabetes management. Previous research has shown that 5-10% of people with pre-diabetes develop type 2 diabetes each year, and that lifestyle changes can prevent or delay this progression. However, most earlier studies focused on whether programs work, not on why people struggle to use them. This Singapore study fills that gap by showing the real-world barriers and supports that affect whether people can actually stick with lifestyle changes in their daily lives.
This study has several important limitations. With only 13 participants, the findings may not apply to all people with pre-diabetes in Singapore or other countries. All participants were recruited through healthcare clinics, so the study missed people who avoid doctors entirely—who might have very different experiences. The study was conducted in one healthcare system, so results may differ in other settings. Additionally, because this is qualitative research based on interviews, it describes experiences and patterns rather than measuring how many people face each barrier or benefit from each support.
The Bottom Line
If you have pre-diabetes: (1) Seek support from family and friends to help you make diet and exercise changes—this support matters as much as medical advice. (2) Find a healthcare provider who listens to your concerns and takes time to understand your situation. (3) Be honest about obstacles like work stress, cost, and time constraints—your doctor can help problem-solve with you. (4) Know that struggling with lifestyle changes is normal and common; you’re not alone. Healthcare systems should: (1) Reduce wait times and allow doctors more time per patient. (2) Create screening programs that reach more people early. (3) Develop culturally appropriate programs that fit people’s real lives, not just ideal situations.
This research is most relevant for people recently diagnosed with pre-diabetes, their family members, healthcare providers treating pre-diabetes, and policymakers designing health programs in Singapore and similar multiethnic communities. It’s particularly important for people who feel overwhelmed by lifestyle change recommendations or who struggle with healthcare access. The findings may be less directly applicable to people in very different healthcare systems or cultural contexts, though many barriers and supports identified are likely universal.
Making lasting changes to diet and exercise typically takes 3-6 months to feel natural, though benefits to blood sugar levels can appear within weeks. However, this study suggests that without ongoing support from family, healthcare providers, and manageable healthcare systems, people often struggle to maintain changes beyond a few months. Realistic expectations: expect the first few weeks to be hardest, look for improvements in energy and how you feel around 6-8 weeks, and plan for ongoing support rather than expecting willpower alone to sustain changes.
Frequently Asked Questions
What are the biggest challenges people face when trying to manage pre-diabetes?
Research from Singapore shows the main obstacles are work stress and time constraints, difficulty sticking with diet and exercise changes, high cost of healthy food, and feeling rushed during doctor visits. Personal struggles with self-discipline and navigating social pressures around eating also significantly impact management success.
What actually helps people with pre-diabetes stay motivated and make changes?
The study identified three powerful motivators: fear of developing type 2 diabetes, support from family and friends in daily life, and having a healthcare provider who listens and shows they care. These social and emotional factors proved just as important as medical advice itself.
How can the healthcare system better support people with pre-diabetes?
Research suggests reducing clinic wait times, allowing doctors more time per patient, reducing clinician rotation, and creating culturally appropriate screening and management programs. The study emphasizes that system improvements are as important as individual behavior change for successful pre-diabetes management.
Why do some people avoid getting screened for pre-diabetes even when programs are available?
Participants described feeling safer not knowing about potential health problems, especially when they had no symptoms. Busy work schedules, cost of screening, and lack of awareness about pre-diabetes risk also prevented people from seeking early detection.
Can traditional or alternative therapies help manage pre-diabetes alongside medical treatment?
The study found that some people integrated traditional approaches into their pre-diabetes management. While the research didn’t evaluate effectiveness, it shows that culturally meaningful approaches may help people feel more engaged in their care, though medical supervision remains important.
Want to Apply This Research?
- Track three specific behaviors weekly: (1) Number of days you exercised or moved for 30+ minutes, (2) Number of meals that included vegetables or whole grains, (3) How supported you felt by family or healthcare providers (rate 1-10). This captures both the lifestyle changes and the emotional support that research shows matters most.
- Use the app to set one small, specific goal each week rather than trying to change everything at once. For example: ‘Add vegetables to two dinners this week’ or ‘Take a 15-minute walk three times.’ Share your goal with a family member or friend through the app and ask them to check in with you—the research shows that social support is one of the strongest predictors of success.
- Create a monthly reflection check-in where you review what barriers came up (work stress, cost, time) and what helped you succeed (family encouragement, feeling good after exercise). Use these insights to adjust your goals for the next month. This mirrors the research finding that sustainable change requires addressing real-world obstacles, not just willpower.
This research describes patient experiences with pre-diabetes diagnosis and care in Singapore’s healthcare system. It does not provide medical advice or treatment recommendations. If you have been diagnosed with pre-diabetes or have concerns about your blood sugar levels, consult with your healthcare provider for personalized medical guidance. The findings are based on interviews with 13 people and may not apply to all populations or healthcare settings. Always work with qualified healthcare professionals before making changes to your diet, exercise, or medical care.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.