Male macho attitudes may directly influence the disproportionately higher death rate among young men with diabetes, according to researchers from the University of Southampton in England.
Young male deaths from diabetes are nearly twice the rate of female deaths, according to professors from the university's School of Medicine Mental Health research unit who led the study.
“With more than 200 males to 100 females dying annually, there is evidence that there are still unnecessary deaths from diabetes,” said Professor Colin Pritchard of the University of Southampton.
“Young men resent restrictions being placed on their lifestyle and are not good at considering medium-term futures and are more likely to be attracted to risk,” said Pritchard. “Being diabetic or maintaining a healthy diet is about life boundaries and the desire to over-ride this can result from a 'male macho attitude' which means they are less likely to follow their treatment regime.”
While the incidence of diabetes in youth and young adults has increased, the researchers found that the diabetes death rate has decreased in most countries except for the United States.
They reached their conclusions after analyzing the most recent international mortality statistics gathered by the World Health Organization during the period 1974 to 1997.
Barriers to care
Health outcomes are influenced by a society's culture, by a person's beliefs and attitudes, and by family and friends, according to an article about the psychological barriers to effective diabetes care published by the International Diabetes Federation in 2004.
In addition, the article cites the Diabetes Attitudes, Wishes and Needs (DAWN) Study that found psychological problems common among people living with diabetes. Those psychological barriers pose challenges for successful diabetes self-management.
For example, the authors cite a previous study that found negative perceptions about insulin therapy from type 2 diabetes patients prescribed tablets.
Patients taking tablets expressed fear about dying while asleep due to hypoglycemia induced by insulin. Some cited a fear of pain from insulin injections. Still others perceived the fear of a traumatic lifestyle change due to dependence on insulin. Frustration is another common feeling, as patients perceive a lack of control over their disease should it progress to insulin therapy.
On the flip side, people in the study with type 2 diabetes prescribed insulin therapy typically reacted positively. Many reported that their fears were replaced by positive perceptions once they began insulin therapy. Patients reported a sense of control while on insulin therapy and a lack of blood sugar control while on tablets.
Three basic affirmations are at the core of successful self-management behavior, according to the article: “People with diabetes make the important choices,” “people with diabetes have control,” and “people with diabetes live with the consequences.”
Sources: University of Southampton, International Diabetes Federation