Diabetes self-management and gender disparities
Diabetes is a chronic condition that affects 23.2 million Americans and is particularly prevalent among Hispanics. Effective self-management is crucial in diabetes care and requires that patients adhere to prescription medications, adopt a healthy diet, commit to regular exercise and routinely monitor blood glucose levels.
Depressive symptoms commonly accompany diabetes diagnoses. Depressive symptoms can lead to hopelessness, lack of motivation and reduced engagement in self-management behaviors. Research suggests that women report higher levels of depressive symptoms than men. Depressive symptoms can undermine an individual’s belief in managing their diabetes effectively. Women experiencing higher depressive symptoms may have lower self-efficacy, which is an individual’s belief in their ability to perform specific tasks necessary for effective self-management.
Research indicates that women often report lower self-efficacy levels compared to men. This disparity may stem from sociocultural norms, gender roles, access to resources and healthcare access disparities. Understanding and addressing these underlying gender disparities in self-efficacy is crucial to equitably supporting all individuals with diabetes.
I recently co-authored a study to examine the extent to which perceived support in addressing depressive symptoms affect diabetes management among Hispanic women and men. Our study suggested that perceived support mattered more to women. Among women, the indirect effect of depressive symptoms on self-efficacy was contingent on lower levels of perceived support. Among men, increases in depressive symptoms were directly associated with declines in self-efficacy and were not conditional on perceived support. 
Hispanics, especially women, often rely on family support networks for diabetes management. Perceived support acts as a buffer against the negative impact of stressors and can enhance confidence in one’s ability to self-manage the disease. Women who perceive higher levels of support may have increased self-efficacy, whereas the absence or inadequacy of support may lead to decreased self-efficacy. For Hispanic women, who often take on primary caregiving roles, perceived support may be particularly important. Thus, interventions aimed at enhancing self-efficacy should focus on strengthening social support networks, involving family members and educating healthcare providers on the unique needs and challenges faced by Hispanic women with diabetes.
Interventions targeting self-efficacy should address depressive symptoms by integrating mental health support into diabetes management programs. Culturally sensitive approaches that consider the unique experiences and stressors faced by Hispanic women can help alleviate depressive symptoms and promote better self-efficacy for diabetes self-management.
In conclusion, understanding the gender differences in self-efficacy for diabetes self-management among Hispanics is crucial for developing effective interventions. Perceived support and depressive symptoms play significant mediating roles in this relationship. Targeted strategies that enhance social support networks, address cultural norms and incorporate mental health support can empower Hispanic women to manage their diabetes effectively.
By Dr. Luis Rustveld, assistant professor, Department of Family and Community Medicine, Baylor College of Medicine
