Diabetes-related stigma among adolescents: Emotional self-efficacy, aggressiveness, self-care, and barriers to treatment compliance

Resumen

Recent studies indicate that over 60% of adolescents with type 1 diabetes (T1D) experience diabetes-related stigma (DRS). DRS may affect their emotional self-efficacy, behavior, and self-care, while increasing barriers for compliance with physical and mental health treatment. We compared youths with (G1; n = 35) and without (G2; n = 16) any history of DRS on these domains. Participants were 51 T1D adolescents (aged 12-17 years) enrolled in a depression treatment study (IRB# 1112-005). Using MANOVA followed by individual ANOVAs, we compared groups in continuous variables. To examine the association of DRS with categorical variables, we used Chi-square tests. MANOVA results were significant, F (5, 45) = 3.20, p = .015. G1 reported lower scores than G2 on self-efficacy for depression, perception of therapeutic impact of initial group sessions, and family support to comply with insulin treatment. G1 caregivers perceived their offspring as more aggressive and affected by barriers to treatment adherence than those from G2. In G1, we observed a higher proportion of cases with body mass index problems, poor compliance with their meal plan, and multiple episodes of hypoglycemia. A lower percentage of cases in G1 met the recommended glycemic control levels, compared to their counterparts. Our findings support the relationship of DRS with lower emotional self-efficacy, more behavioral problems, difficulties in food-related self-care, and more barriers to comply with the treatment of diabetes and emotional problems in adolescents. They suggest the need for large-scale education to prevent DRS and psychosocial interventions to combat its impact among youths.

Acknowledgements: Funded by NIDDK (R03DK092547).