From Shock to Restructuring: A Thematic Analysis of Chinese Patients' Diabetes Adaptation in an Online Peer Support Forum

Despite rapid growth of online health communities, little is known about how individuals with diabetes make sense of their condition through asynchronous peer discussion—particularly in non-Western contexts. Aim: This study provides an inductive thematic analysis of patient posts on the Sweet Home Diabetes Forum to uncover the experiential and social processes underpinning diabetes adaptation. Ninety-three posts were randomly sampled from "Type 2 Diabetes" sub-forum. Data were analyzed using reflexive thematic analysis, with iterative coding by two researchers and consensus discussions to ensure interpretive rigor. Three interlinked adaptation phases emerged: Psychological Adjustment: from initial shock and denial to acceptance and resilience-building; Daily Management: flexible dietary strategies, tailored physical activity, and ritualized medication practices; Life Restructuring: financial coping, career recalibration, and value reframing. Peer exchanges fostered collaborative expertise ("epistemic humility governance") and collective identity reconstruction. These findings underscore the importance of online peer forums as phase-specific support arenas—providing critical emotional validation, collaborative skill-building, and life-planning resources—and extend chronic illness adaptation theory into a culturally specific, digitally mediated context.