Understanding Barriers and Facilitators to Diabetes Self-Management among Burmese Refugees in the U.S.: A Qualitative Study

Abstract: Burmese refugees are among the most widely displaced populations and were the largest ethnic refugee group resettled in the United States from 2011 to 2024, yet they remain underrepresented in diabetes research. This study explored experiences with type 2 diabetes mellitus (T2DM) among Burmese refugees to identify sociocultural and structural factors shaping self-management. Using a qualitative clinical ethnographic design, we conducted in-depth interviews with 15 Burmese refugees with T2DM between August and November 2023 in participants' native languages. Interviews were transcribed, translated, and analyzed using applied thematic analysis. Seven themes emerged: low health literacy, language barriers, provider relationships, cultural influences, social support, financial constraints, and psychological well-being. Participants described reliance on traditional practices and challenges related to trauma and economic insecurity, while faith and community support facilitated resilience. Findings underscore the need for linguistically accessible, culturally grounded, community-based diabetes care that addresses structural barriers and integrates social and religious resources.