Impact of Gender on Patient Experiences of Self-Management in Type 2 Diabetes: A Qualitative Study

Abstract

Anna Ramírez-Morros,1– 3,* Anna Berenguera,4,* Laura Millaruelo,3 Pilar Buil-Cosiales,3,5– 7 Carmen Gomez Garcia,3,8 Xavier Cos,3,9,10 Luis Ávila Lachica,3,8 Sara Artola,3,11 Jose Manuel Millaruelo,3,12 Didac Mauricio,1,9,13– 15 Josep Franch-Nadal1,3,9,16 1DAP-Cat Group, Unitat de Suport a la Recerca de la Catalunya Central, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sant Fruitós de Bages, Spain; 2Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain; 3red GDPS Foundation, Sabadell, Spain; 4Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; 5Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; 6Atención Primaria, Servicio Navarro de Salud, Navarra, Spain; 7IdiSNA, Instituto de Investigación Sanitaria de Navarra, Navarra, Spain; 8Unidad de Gestión Clínica Vélez Norte, Vélez-Málaga, Servicio Andaluz de Salud, Vélez-Málaga, Spain; 9Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Barcelona, Spain; 10EAP Sant Martí, Institut Catalá de la Salut, Barcelona, Spain; 11Centro de Salud José Marvá, Madrid, Spain; 12Centro de Salud Torrero La Paz, Zaragoza, Spain; 13Institut de Recerca Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 14Department of Endocrinology and Nutrition, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain; 15Department of Medicine, University of Vic – Central University of Catalonia, Vic, Spain; 16Equip d’Atenció Primària (EAP) Raval Sud-Gerencia Territorial Barcelona, Institut Català de la Salut, Barcelona, Spain*These authors contributed equally to this workCorrespondence: Anna Ramírez-Morros, Unitat de Suport a la Recerca de la Catalunya Central, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, 08272, Spain, Tel [phone], Email [email protected] Josep Franch-Nadal, Unitat de Suport a la Recerca de Barcelona, Barcelona, 08025, Spain, Tel [phone], Email [email protected]: This study aims to identify gender disparities in knowledge, attitudes and behaviors related to self-management and control of Type 2 diabetes Mellitus (T2DM) among primary care patients. The research was conducted across multiple Spanish cities.Patients and Methods: The study involved 8 Primary Care Centres located in four distinct regions of Spain: East (Barcelona), Centre (Madrid), North (Pamplona and Zumaia) and South (Vélez-Málaga and Málaga). A total of 111 individuals diagnosed with T2DM, comprising 52 women and 59 men, participated in 12 group discussions at these primary healthcare centers from February to June 2015. Participation was voluntary, and all participants provided informed consent by signing the consent form. A qualitative hermeneutic phenomenological study with a maximum variation sample was done. Participant profiles were defined based on gender, age, place of residence, type of treatment, years living with T2DM and the presence or absence of a cardiovascular event. Thematic analysis was used to analyze the data.Results: Participants were aware that diabetes is a chronic condition, with varied levels of concern regarding the diagnosis. Participants’ locus of control influenced their perception of the disease’s cause, with women attributing it to stress and emotional situations, while men linked it to risky behaviors. Self-management strategies were shaped by beliefs about diabetes, with both genders facing challenges in implementing recommended practices. Gender differences were also evident in caregiving roles, with men receiving more family support for diet adherence, while women prioritized family needs over their self-care. Participants expressed satisfaction with professional-patient interactions but highlighted the need for more accessible information and specialist care, suggesting support groups for women and clear health guidelines for men.Conclusion: Gender differences significantly influence how patients perceive and manage type 2 diabetes, with women experiencing greater concern and care burden compared to men. Effective diabetes management requires tailored support that addresses these gender-specific challenges. Enhancing healthcare services with clear guidelines and support groups can improve self-management outcomes in both men and women.Keywords: gender, type 2 diabetes mellitus, self-care, personal experience

Keywords

• gender
• type 2 diabetes mellitus
• self-care
• personal experience