Gender Differences in Functional Limitations in Adults Living with Type 2 Diabetes: Biobehavioral and Psychosocial Mediators
Abstract
BACKGROUND: Differences in functional limitations between adults with and without diabetes are more evident in women than they are in men. PURPOSE: This study aims to investigate if there are gender differences in biological, behavioral, and psychosocial variables, and how these gender-related variables explain the gender-functional limitations relationship in adults with type 2 diabetes. METHODS: We drew data on 1,619 adults with type 2 diabetes from the Health and Retirement Study and its diabetes-specific mail survey. The fit of a series of mediation models to the data was assessed by structural equation modeling. RESULTS: Although women had better diet and blood glucose self-monitoring behaviors than did men, they reported less favorable body mass index, glycosylated hemoglobin (HbA1c) value, blood pressure, early complications, exercise behaviors, perceived control, self-efficacy, coping, depressive symptoms, and family support than did men. Psychosocial factors made an indirect contribution in the gender-functional limitations relationship by way of their strong association with biological and behavioral factors, two factors that directly and completely mediated the gender-functional limitations relationship. CONCLUSIONS: Interventions promoting psychosocial well-being and empowering perceived diabetes control, coping, and self-efficacy in women with type 2 diabetes may help improve biological and behavioral determinants, and further, their long-term functional health.
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Females with T2DM exhibit inferior glycemic control and are less likely to achieve their HbA1c targets.
“Cumulative evidence suggests that females with T2DM exhibit inferior glycemic control and are less likely to achieve their HbA1c targets [15].”
From Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care (2022) · cites this paper as [15]
Patients with type 2 diabetes may have significant functional limitations, transportation challenges, or insufficient time to attend in-person visits.
“patients with T2D may have significant functional limitations, transportation challenges, or insufficient time to attend in-person visits [81–83].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [81]
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- Authors
- Chiu, C.-J., & Wray, L. A.
- Affiliations
- Pennsylvania State University (US)
- ORCID
- Chiu, Ching-Ju
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-09-09
- Volume
- 41
- Issue
- 1
- Pages
- 71-82
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- OpenAlex
- W2007041833
- Cited by
- 84
- References
- 74
- Citations by year
- 2025: 2 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 10 · 2020: 4 · 2019: 4 · 2018: 6 · 2017: 11 · 2016: 6 · 2015: 9 · 2014: 9 · 2013: 3 · 2012: 1
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R21DK078894)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- type 2 diabetes, functional limitations, gender differences, women, psychosocial factors, perceived control, self-efficacy, coping, depressive symptoms, family support, self-monitoring of blood glucose, diet, exercise behavior, HbA1c, body mass index, blood pressure, diabetes complications, mediation
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Models, Psychological, Prospective Studies, Risk Factors, Sex Characteristics, Socioeconomic Factors, United States, Blood Glucose Self-Monitoring, Biomarkers, Health Behavior, Exercise, Body Mass Index, Self Report
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