Abstract: Objective: To explore the motivations and barriers to lifestyle changes in young and middle-aged patients with Type 2 Diabetes Mellitus (T2DM) and inform intervention studies. Methods: In-depth semi-structured interview was conducted with 13 young and middle-aged T2DM inpatients in a tertiary grade A hospital in Tianjin from September to October 2024, purposive sampling method was used to select patients. The phenomenological method and content analysis were applied to analyze the interview data. Results: Three main themes emerged regarding motivations: perceived risk of diabetes, susceptibility to complications, and benefits of a healthy lifestyle. Barriers to lifestyle change were categorized into four themes: difficulties in changing dietary habits, lack of disease symptoms, work-related and dining constraints, and social gatherings leading to relaxed control. Conclusion: Young and middle-aged T2DM patients face specific barriers and facilitators to lifestyle changes. Clinical staff should address these barriers through targeted education to enhance healthy lifestyle adherence.

Key words: diabetes mellitus; lifestyle change; motivation; barrier; qualitative study