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.