title: Denial of disease in Type 2 diabetes mellitus: its influence on metabolic control and associated factors.
abstract: OBJECTIVE
  We have investigated denial of disease in patients with Type 2 diabetes mellitus (DM) and its possible association with metabolic control, and with 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 < or = 5 years since diagnosis (73 patients) and with > 5 years (87). The group without social security had higher scores of perceived stress, and lower scores of social support, knowledge about diabetes and belief in conventional medicine; denial, however, was similar in the two groups with or without social security. Multiple regression analysis showed that denial of disease was positively associated with HbA1c in the total group (P < 0.001), in the groups with < or = 5 and > 5 years since diagnosis, as well as in the groups with or without social security. Denial was also associated with years since diagnosis (P = 0.009) for the group with < or = 5 years since diagnosis.
  
  
  CONCLUSIONS
  We concluded that, in patients with Type 2DM 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 knowledge of diabetes, belief in conventional medicine, social support or perceived stress.
authors.affiliation: Instituto de Investigaciones Médicas, Universidad de Guanajuato, León, Mexico.
authors.forename: M E
authors.initials: ME
authors.lastname: Garay-Sevilla
authors.forename: J M
authors.initials: JM
authors.lastname: Malacara
authors.forename: A
authors.initials: A
authors.lastname: Gutiérrez-Roa
authors.forename: E
authors.initials: E
authors.lastname: González
mesh_terms: D003430:Cross-Sectional Studies; D003717:Denial, Psychological; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D012044:Regression Analysis; D012944:Social Support; D013315:Stress, Psychological; D011795:Surveys and Questionnaires