1- Department of Sociology, Faculty of Social Sciences, Payame Noor University, Tehran, Iran. , a-alizadeh@pnu.ac.ir
2- Department of Sociology, Faculty of Social Sciences, Payame Noor University, Tehran, Iran.
3- Department of Sociology, Faculty of Social Sciences, Kharazmi University, Tehran, Iran.
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Abstract
Introduction: Diabetes is one of the chronic diseases which causes other chronic diseases. The incidence of it is increasing in different societies, including Iran. This study aimed to investigate Gender differences in incidence of type 2 diabetes and related psychosocial factors.
Methods: This was a cross-sectional study conducted in 2019 among people with the age group of 20 to 60. All the 600 participants were married and lived in Kerman. Using multi-stage sampling, 300 men and 300 women were selected. Data were collected through a questionnaire which included 3 sections as follows: Social demographic variables, healthy lifestyle variable and perceived stress variable. Statistical analysis was done through descriptive statistics, Lambda test, Independent sample T -test and Binary Logistic regression. The SPSS 23 was used to perform the data analysis. The significance level was considered to be 5%
Results: The mean (SD) score of physical activity for women was significantly lower than men: (7.6 (2.3) vs. 8.2 (2.7) (P=0.006) ). In the same vein, the mean (SD) score of healthy diet among women was significantly higher than men: (18.6 (3) vs. 18 (2.4),( P<0.001) ). The rate of avoidance of tobacco and alcohol consumption among women was significantly higher than men: (19.4 (1.3) vs. 17.9 (2.6),( P<0.001) ). Results of multiple logistic regression showed that in the group of women, the chance of developing diabetes was significantly related to perceived stress level (OR=1.21), level of sports activities OR=0.48) (and education. Education level and health diet also had a significant effect on men's odds of developing diabetes (OR=0.63, 1.35, respectively).
Conclusion: Among the indicators of healthy lifestyle, doing exercise in women and having a healthy diet in men were effective in predicting the risk of diabetes. In addition, the amount of perceived social stress was one of the most important psychological factors in the development of diabetes just in women. Therefore, it is crucial to recognize the factors affecting diabetes in both men and women separately and This can be an appropriate analytical instrument for sociologists and health researchers to recognize and focus on this problem as well as for health policy makers to reduce and control harmful factors.
Keywords: Gender difference, Type 2 Diabetes, Social factors, Perceived Stress
Introduction
Diabetes is one of the chronic diseases with no definitive treatment (1). On the other hand, in 2019 edition of the IDF Diabetes Atlas, the prevalence of diabetes was estimated to be 463.0 million adults aged 20 –79 worldwide. Based on the 2019 estimates, by 2045,700.2 million adults have diabetes (2). In Iran, the prevalence of diabetes in adults was 11 %, in the age range of approximately 25 to 70 in 2019 (3).
This shows a 35% increase compared to 2005. It is estimated that by 2030, approximately 9.2 million Iranians will develop diabetes (4).
Type 2 diabetes epidemic is associated with rapid cultural change, aging populations, increasing urbanization, mechanization, and industrialization, leading to changing lifestyles in communities. They include changes in eating habits and a tendency toward eating ready-to-eat food and fast food, reduced physical activity, exercise, sedentary lifestyle, and consequently, obesity and weight gain, increased stress, and in general, unhealthy lifestyle and behavioral patterns (5). In fact, one of the main mechanisms by which health is socially constructed or destroyed is a health-related lifestyle (6). Therefore, studying these risk factors in the context of any society is important and can be helpful regarding prevention and treatment of the disease (7). Healthy lifestyle seeks to form such behaviors that help maintain people's health and prevent high-risk behaviors (8). Another risk factor is psychological stress. Regarding the relationship between stress and diabetes, the authors suggest that increased stress can lead to increase of type 2 diabetes (9). By secreting the hormones such as cortisol and adrenaline, which are anti-insulin, stress can cause type 2 diabetes (10). On the other hand, stress can indirectly affect the risk of developing diabetes through specific behaviors associated with health just as it can affect the risk of developing diabetes by reducing exercise (11). Stress, physically and mentally, affects people. As shown in some studies, psychological stress has doubled diabetes (12) and research in Sweden has demonstrated that chronic stress (stress at home and at work) increased the risk of type 2 diabetes by about 45% (13). Because chronic stress and the stress caused by people's social roles in life are increasing every day and human beings are now facing a set of stressors, many people are indirectly affected (14). Due to the chronic, non-communicable and costly nature of diabetes for public health, it puts a lot of burden on the individual, family, the community and country and. It threatens the life quality of patients leading to complications. Most of the data on the population of Western Europe or Asia reveals that the prevalence of type 2 diabetes is higher in men than women (15,16). However, the situation is different in each region. For example in was no gender difference regarding the disease (17). However, contrary to global statistics, the prevalence of type 2 diabetes in Iran is higher in women than men (18). The results of research (18, 19) also confirmed that type 2 diabetes is more common in women than men in Iran. Therefore, due to the growing rate of diabetes in Iran and the consequent rise in financial and social costs, it is crucial to identify the social and psychological predictors of type 2 diabetes for both men and women as separate cases. Understanding gender differences can help create fairer health systems and policies to prevent the disease. The aim of this study is to evaluate the rate of type 2 diabetes in men and women and identify the social and psychological factors affecting the incidence of type 2 diabetes in women compared to men.
Methods
According to the World Health Organization, the prevalence of diabetes in Iran in 2021 was about 9% (https://worldpopulationreview.com/ country-rankings/diabetes-rates-by-country). Based on this, using the formula for calculating the sample size in terms of proportion (Cochran's formula) and considering the level of significance of 5 percent, accuracy of 3 percent (d=0.03)) and placement in the formula below sample size of 350 people is obtained.