Diabetes-Related Stigma and its Influence on Social Networks, Social Support, and HbA1c in Ghana

Objective: We applied a social network approach to examine if three types of diabetes-related stigma (self-stigma, per­ceived stigma and enacted stigma) moder­ated associations between social network characteristics (network size, kin composi­tion, household composition, and network density), social support, and blood glucose among Ghanaians with type 2 diabetes mel­litus (T2DM).Methods: Data were obtained through a cross-sectional survey of 254 adults at a diabetes clinic in Ghana that assessed participants’ social networks, social support, and frequency of experiencing three types of diabetes-related stigma.Results: Self-stigma moderated associa­tions between kin composition and social support when controlling for network size (β=-.97, P=.004). Among study participants reporting low self-stigma, kin composition was positively associated with social support (β=1.29, P<.0001), but this association was not found among those reporting high self-stigma. Network size was positively associ­ated with social support among participants reporting both low and high self-stigma. None of the types of diabetes-related stigma moderated other associations between social networks, social support, and blood glucose.Conclusions: Individuals with T2DM who report high self-stigma may have lower social support, which can reduce their capacity for disease management. Addition­ally, larger social networks may be beneficial for individuals with T2DM in countries like Ghana, and interventions that expand network resources may facilitate diabe­tes control. Ethn Dis.2020; 31(1):57-66; doi:10.18865/ed.31.1.57