The impact of diabetes stigma on psychological, behavioral and clinical outcomes in young and middle-aged Chinese patients with type 2 diabetes mellitus: the moderating effects of psychosocial factors.

OBJECTIVE

Diabetes stigma may lead to poor psychological health and self-management behaviors, resulting in adverse clinical outcomes. This study aimed to explore the associations between diabetes stigma and psychological, behavioral, and clinical outcomes and the moderating effects of hope, self-esteem, and social support in young and middle-aged Chinese patients with type 2 diabetes mellitus (T2DM).

METHODS

A cross-sectional investigation (N = 300) was conducted. First, diabetes stigma, psychological (anxiety, depression, and distress), behavioral (diet, exercise, blood glucose testing, and foot care), and clinical outcomes (baseline HbA1c) and psychosocial moderators (hope, self-esteem, and social support) were assessed. Second, 3-month post-discharge HbA1c was assessed. Linear regression models were used to analyze data.

RESULTS

Diabetes stigma was positively associated with anxiety, depression, and distress. Hope negatively moderated the association between public stigma and anxiety. Hope and self-esteem negatively moderated the associations between diabetes stigma and depression. Social support negatively moderated the association between public stigma and depression. Self-esteem positively moderated the association between self-stigma and distress.

CONCLUSIONS

Decreasing diabetes stigma can improve psychosocial health among young and middle-aged Chinese patients with T2DM, and interventions targeting hope, self-esteem, and social support can decrease the negative impact of diabetes stigma on psychological outcomes.