'This disease would suit better those who have money': Insulin-Treated Diabetes Illness Experience in rural Malawi.

Background: Understanding the illness experience among rural-based insulin-treated diabetic patients has implications for practice and policy. However, there is a lack of in-depth knowledge about insulin-treated diabetic patients' illness experiences in rural Malawi. We explored the experiences of people living with insulin-treated diabetes in rural Malawi. Research Designs and Methods: The study used a qualitative narrative inquiry. Participants were identified at Kamuzu Central Hospital Diabetes Clinic. The hospital is a tertiary level health care facility. We purposively selected 10 participants from rural areas attending the clinic. Data were collected through in-depth interviews in the privacy of the homes of the study participants and analysis was done using Riessman approach of thematic narrative analysis. Results: The following five themes emerged: (1) diabetes perceived as the illness for the rich; (2) 'everything is on a standstill'; (3) dietary challenges of the diabetes illness experience; (4) drug-related challenges associated with the diabetes illness experience and (5) experiencing physical effects of the diabetes illness. Conclusion: Rural-based insulin-treated diabetic patients struggled to live with the illness in the context of low resources. There is a need for multi-factorial approaches at both the community and system levels so as to support people living with diabetes in the rural areas in order to improve their experiences.