Denial of disease in Type 2 diabetes mellitus: its influence on metabolic control and associated factors

Aims We have investigated denial of disease in patients with Type 2 diabete s mellitus (DM) and its possible association with metabolic control, and wi th psychosocial variables: satisfaction with medical care, perceived stress , social support, knowledge of diabetes and belief in conventional medicine . Methods We studied 160 patients in a cross-sectional design, in two groups: with (70) and without social security coverage (90). The mean age for the total group was 53.6 years, with a known diabetes duration of 8.1 years. Results Denial of disease was similar in those with less than or equal to 5 years since diagnosis (73 patients) and with > 5 years (87). The group wit hout social security had higher scores of perceived stress, and lower score s of social support, knowledge about diabetes and belief in conventional me dicine; denial, however, was similar in the two groups with or without soci al security. Multiple regression analysis showed that denial of disease was positively associated with HbA(1c) in the total group (P < 0.001), in the groups with less than or equal to 5 and > 5 years since diagnosis, as well as in the groups with or without social security. Denial was also associate d with years since diagnosis (P = 0.009) for the group with less than or eq ual to 5 years since diagnosis. Conclusions We concluded that, in patients with Type 2 DM denial of disease increases with time during the first 5 years of evolution of diabetes; is associated with poor metabolic control; but is not associated with knowledg e of diabetes, belief in conventional medicine, social support or perceived stress.