Health Care Avoidance and Information-Seeking Among Young Adults With Early-Onset Type 2 Diabetes: Associations With Stigma and Mental Health

OBJECTIVE Diabetes stigma and poor mental health may contribute to health care avoidance, but these associations have received limited attention among young adults with early-onset type 2 diabetes (T2D). This study examined associations of diabetes stigma and mental health with health care avoidance and use of diabetes information sources among young adults with early-onset T2D. RESEARCH DESIGN AND METHODS A sample of 350 young adults aged 18–39 years with early-onset T2D completed a cross-sectional survey measuring diabetes stigma, depressive symptoms, anxiety symptoms, diabetes distress, health care avoidance, and use of eight sources of diabetes-related information. RESULTS After adjusting for covariates, we found diabetes stigma (β = 0.29, P < 0.001), depressive symptoms (β = 0.17, P < 0.001), anxiety symptoms (β = 0.19, P < 0.001), and diabetes distress (β = 0.26, P < 0.001) were each positively associated with health care avoidance. Diabetes stigma was associated with less use of family for diabetes information and greater use of support groups, social media, and websites. Depressive symptoms, anxiety symptoms, and diabetes distress were associated with less use of health care professionals as information sources; depressive symptoms were also associated with less use of family and friends. Diabetes distress was associated with greater use of friends, support groups, social media, artificial intelligence tools, websites, and printed materials for diabetes information. CONCLUSIONS Diabetes stigma and mental health are linked to health care avoidance and the ways young adults with early-onset T2D obtain diabetes information. These findings extend existing evidence from middle-aged and older adults with T2D to suggest that associations between diabetes stigma, poor mental health, and health care avoidance can emerge during young adulthood.