Table 2:

Health care challenges described by study participants

Theme	Quotations
Multiple medical appointments and care providers	They’ll [providers] set up appointments and then they’ll end up having appointments at the same time. … Or sometimes they’ll set up an appointment for me on this day and then the next one is on the next day, instead of trying to set them up so one’s in the morning and one’s in the afternoon. — FG2 (T2MAdvanced)
Not enough time with health professionals	I go and see the diabetic doctor. First of all, they’ve only got 10 or 15 minutes, because they just don’t get any time. There are too many patients. — FG1 (T2MAdvanced)
Care fragmentation and silos	Say you have a number on 1 [blood test] and it’s out of range, they’re like, well, you’ll have to talk to this specialist about that. We don’t deal with that. — FG1 (T2MAdvanced) And this group that we dealt with for years, the social worker, the dietitian … all of a sudden, they came in, shook my hand, said it’s been nice knowing you, basically. And the minute we crossed the hall, all the people were gone out of the system, never to be dealt with again. And no one had ever said to us, at any time, when this happens, you’re going to lose all these support people you’ve had for all this time. — FG1 (T2MDialysis) I keep bringing up, you guys have gone to computers, why can’t you look this stuff up, all the blood tests, all the results? It’s there in front of you, you type in my ID number and everything comes up. So, why can’t you do that? — FG1 (T2MAdvanced) The specialist is supposed to have the record and he says no I don’t have the records. … And I think the most important thing is the records belong to me. I should have it myself before everybody else because I go to different places and I don’t know what’s going on. — FG3 (T2MDialysis) But it would be nice if they would all get together and say, okay, this is what we need. — FG2 (T2MAdvanced)
Communication gaps	I told her when I do this you have to do this, and she just didn’t even listen to me. She opened the thing and my clamp opened and blood went everywhere. — INT1 (T2FDialysis)
Not enough education	When I was diagnosed, it’s almost like the doctors are afraid to tell you what’s going to happen to you. … They don’t want you to freak out about it, so they either sugar coat it, or like, well, you’re not that bad now. — FG1 (T2FAdvanced)
Cost of diabetes management	In terms of the cost, a lot of things aren’t covered. Needles for insulin are not, which I have a bone to pick with that. — FG1 (T2MDialysis)
Access to technology	That would boggle my mind that they would create a piece of machinery for you to test your blood glucose. … A lot of diabetics have low vision and you have the instructions on the machine itself, error message and stuff there and you can’t see them. I just ignore them. — FG4 (T2MDialysis)
Diets	With [diabetes] we were taught to eat whole wheat breads and with the renal disease you’re taught not to eat any of that, you’re taught to eat white so the 2 diets kind of counteract. Like they’re telling you 1 thing for sugar and they’re telling you 1 thing for renal, so yeah there is a big change. — INT3 (T2FDialysis)