Background: Steno Diabetes Center Nordjylland (SDCN) wants to change the approach for treatment in the outpatient clinics for people with diabetes from a fixed standardized treatment to an individual needs-driven treatment. The aim is that people no longer have to come to treatments they do not feel a need for. This will release ressources for those with greater needs for treatment and at the same time increase patient satisfaction across all people associated with outpatient treatment. For some, the new treatment approach will lead to increased self-management, which is why it is problematic, if they are not able to do this.

Purpose: The purpose of this project was to examine which barriers and facilitators people with diabetes, associated with an outpatient treatment in Region Nordjylland, experience in relation to self-management of diabetes. This knowledge was supposed to contribute to proposals for change for future practice, so that people with diabetes are supported in the best possible way in self-management.

Methods: This project was based on a philosophical hermeneutic scientific theoretical approach. Interviews were conducted with 8 people with diabetes, which was analyzed with a hermeneutic analysis strategy. In addition, a systematic literature search was carried out as well as an interview of a diabetes nurse associated with SDCN, which was used for the discussion of the results.

Resultater: Facilitators for self-management were acceptance of diabetes, social support from the circle of friends and the health professional, digital help and medical technology. Barriers for self-management were lack of social support from the social network, physical and emotional consequences of diabetes, comorbidities, financial challenges, failure to initiate contact when help is needed and challenges in assessing one's need for help. Based on the results, proposals were developed for what changes can be made in future practice to meet these barriers and facilitators.

Conclusion: In order to meet the unintended consequences that the needs-driven treatment approach may be associated with, it is recommended that the SDCN, as far as possible, takes into account the facilitators and barriers to self-management through the inclusion of the change proposals developed in this project.