A Cross-Sectional Analysis of the Stigma Surrounding Type 2 Diabetes in Colombia

Int J Environ Res Public Health. 2021 Dec 1;18(23):12657. doi: 10.3390/ijerph182312657.

Abstract

Type 2 diabetes is a global epidemic, and many people feel stigmatized for having this disease. The stigma is a relevant barrier to diabetes management. However, evidence in this regard is scarce in Latin America. This study aimed to analyze the level of stigma surrounding type 2 diabetes in the Colombian population and its relationships with sociodemographic, clinical, psychosocial variables and behaviors related to management of the disease (self-management behaviors). This cross-sectional study included 501 Colombian adults with type 2 diabetes. We estimated the relation between stigma and selected variables through linear regression models. Additionally, we analyzed the mediator role of psychosocial variables in the relationship between stigma and self-management behaviors through structural equation models. A total of 16.4% of patients showed concerning levels of stigma. The time elapsed since diagnosis (β = -0.23) and socioeconomic status (β = -0.13) were significant predictors of the level of stigma. Stigma was negatively correlated with self-efficacy (β = -0.36), self-esteem (β = -0.37), and relationship with health care provider (β = -0.46), and positively correlated with stress (β = 0.23). Self-efficacy, self-esteem, and the relationships with health care providers had a mediation role in the relationship between stigma and self-management behaviors. These variables would be part of the mechanisms through which the perception of stigma harms self-management behaviors. The stigma of type 2 diabetes is frequent in the Colombian population and negatively associated with important aspects of disease management.

Keywords: self-management; social stigma; type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Colombia / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / epidemiology
  • Humans
  • Self Concept
  • Social Stigma