Managing health in dual diagnosis: narratives from individuals with schizophrenia and diabetes.

Introduction: Schizophrenia, often accompanied by cognitive impairments, increases the risk of diabetes, complicating self-care and overall health management. Exploring the lived experiences of individuals who face both mental and physical illness-and, in many cases, pronounced cognitive or functional challenges-is critical for developing more effective and integrated care strategies. Aim: This study examined the daily lives of individuals living with schizophrenia and diabetes, focusing on their health-related experiences and interactions with healthcare services. Methods: Twenty-two participants diagnosed with schizophrenia and type 1 or type 2 diabetes, including individuals with significant cognitive and functional impairments, were interviewed in a qualitative study. Data were analyzed using thematic analysis grounded in descriptive phenomenology. Results: Three themes captured participants' experiences: (1) Perceptions of health shaped by personal narratives, including the role of insight, autonomy, and meaning; (2) Struggles with navigating health in daily life, as participants balanced medication effects, symptoms, and practical constraints while attempting recommended routines; and (3) Need for formal support in managing health, with valued help often being concrete, everyday assistance alongside respectful, encouraging relationships with providers. Conclusion: These findings highlight the importance of holistic, coordinated care that integrates mental and physical health, addresses practical barriers, and fosters self-understanding. By including participants with cognitive impairments, this study adds new insight into how such challenges influence daily health management and the types of support needed to sustain engagement in care.