Gender differences in functional limitations in adults living with type 2 diabetes: biobehavioral and psychosocial mediators

Ann Behav Med. 2011 Feb;41(1):71-82. doi: 10.1007/s12160-010-9226-0.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Glucose Self-Monitoring
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology*
  • Exercise
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Middle Aged
  • Models, Psychological*
  • Prospective Studies
  • Risk Factors
  • Self Report
  • Sex Characteristics
  • Socioeconomic Factors
  • United States / epidemiology


  • Biomarkers