What is the clinical evidence from this study?

Study design: Observational. Population: Type 2 diabetes (n=17). Intervention: Racial discrimination-related stress. Primary outcome: Themes related to behavioral changes for T2D management.

What does this research mean for the field?

In the context of racial discrimination-related stress, Black men and women with Type 2 diabetes exhibit distinct coping mechanisms—such as avoidance coping in men and the superwoman schema in women—that differently impact their dietary choices and disease management. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to understand how racial discrimination-related stress impacts Black adults' behavioral changes for managing type 2 diabetes.

June 7, 2026

2797-LB: Gender Differences in the Management of Type 2 Diabetes in the Context of Racial Discrimination–Related Stress

Key Result

Racial discrimination-related stress influenced type 2 diabetes management in 17 Black adults, with men engaging in avoidance coping and women endorsing the superwoman schema.

Key Points

This study aims to understand how racial discrimination-related stress impacts Black adults' behavioral changes for managing type 2 diabetes.
Conducted semi-structured in-depth interviews with Black adults aged 18 or older diagnosed with type 2 diabetes.
Interviews were held in Prince George’s County, Maryland and Metro Detroit, Michigan from September to December 2024.
Core narratives were constructed using latent thematic analysis to identify patterns in participant experiences.
Six key themes emerged, including the influence of family dynamics on diet and coping mechanisms for managing stress.
Male participants demonstrated avoidance coping strategies, while female participants faced added stress from the superwoman schema.
Findings highlight the importance of support systems and address the need for better patient-provider engagement in diabetes management.

Study Design

Type

Observational (n=17)

Multicenter

Yes

Structured PICO

Population

17 Black adults aged 18 years or older with type 2 diabetes participated in semi-structured interviews to explore the impact of racial discrimination-related stress.

Exposure

One-hour, semi-structured in-depth interviews

Outcome

Underlying patterns and shared meanings regarding how racial discrimination-related stress impacts behavioral changes for T2D managementpatient reported

Gender differences exist in coping mechanisms for racial discrimination-related stress among Black adults with T2D, which may impact dietary changes and self-management.

Abstract

Introduction and Objective: In the United States, Black adults have a high incidence of type 2 diabetes (T2D) and T2D-related mortality rates. T2D risk factors include chronic stress; physical inactivity; obesity or overweight; living with prediabetes; and being older (over age 45). Black Americans face increased exposure to psychological stressors (e.g., racial discrimination) that increase T2D risk. This study explored how racial discrimination-related stress impacts Black adults’ ability to make behavioral changes to improve T2D management. Methods: Black adults 18 years of age or older living in Prince George’s County, Maryland or Metro Detroit, Michigan, with a clinical diagnosis of T2D, were recruited to participate in one-hour, semi-structured in-depth interviews. Interviews were conducted between September-December 2024. Core narratives were constructed using latent thematic analysis to identify underlying patterns and shared meanings, and to examine social contexts shaping participant experiences. Results: Seventeen individuals participated. Six themes were identified: (1) A change in family dynamics influences diet; (2) Standing firm and unshaken; (3) With age comes increased knowledge; (4) Change comes from within; (5) Partnership with healthcare provider; and (6) Relying on God and community. Spousal support and familial loss were key drivers of food choices for male participants. Male participants engaged in avoidance coping, while female participants endorsed the superwoman schema and its added stress, which contributed to dietary changes for some respondents. Conclusion: Future research should improve methods for capturing often-suppressed experiences of racial discrimination. This research can be used to strengthen patient-provider engagement and advance evidence-based T2D self-management approaches. Disclosure A. Ewen: None. J. Hawkins: None. C.S. Fryer: None. Funding Ann G. Wylie Dissertation Fellowship; Barry Portnoy Dissertation Research Award; National Institutes of Health (P30 AG015281); Michigan Center for Urban African American Aging Research (MCUAAAR)

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