• Leandris C Liburd, Apophia Namageyo-Funa, and Leonard Jack.
• Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. lel1@cdc.gov
• J Natl Med Assoc. 2007 May 1;99(5):550-2, 554-8.

AbstractAfrican-American men bear a greater burden of type-2 diabetes and its associated complications. The purpose of this analysis was to explore in greater depth themes that emerged in illness narratives of a small sample of African-American men living with type-2 diabetes. The primary theme that is the focus of this article is the lived experience of black manhood and masculinity and its intersection with the challenges of diabetes self-management. In-depth interviews with 16 African-American men who had established type-2 diabetes yielded thematic analyses of four questions: (1) What do you fear most about having diabetes? (2) In what ways have people in your life treated you differently after learning you have diabetes? (3) In what ways has knowing you have diabetes affected the way you see yourself? and (4) What are some reactions when you tell people you have diabetes? This preliminary study suggests that the requirements of diabetes self-management often run counter to the traditional sex roles and learned behaviors of African-American men, and this can contribute to nonadherence to medications and poor glycemic control. Gender identity is a key cultural factor that influences health-related behaviors, including how men with type-2 diabetes engage with the healthcare system and manage their diabetes. Understanding African-American men's gender identity is an important component of cultural competency for physicians and can be consequential in patient outcomes.

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