Black men with Type 2 diabetes who report more discrimination in medical settings talk less about their diabetes with the people around them, according to new research led by Tyler Prochnow, an associate professor at the Texas A&M School of Public Health.

That matters because those conversations are closely tied to how well men take care of themselves. The men who talked about their diabetes more were also the ones keeping up with their self-care.

The findings come from a national survey of 1,225 Black and African American men living with Type 2 diabetes, published across two studies in the Journal of Racial and Ethnic Health Disparities and Social Science & Medicine.

The researchers asked men how often they experienced discrimination in medical settings, such as being treated with “less respect than other people” when they went to a doctor’s office.

Men who reported more of that treatment did not pull away from people. They actually talked with their friends and family more overall. What changed was the subject. They talked about their diabetes less.

Prochnow described it as “a specific protective response, shutting down the topic that made you vulnerable,” while keeping relationships intact. “What goes quiet is the health conversation specifically,” he said in a Texas A&M release published October 28.

Put simply, the chain runs like this. A bad experience with the healthcare system makes diabetes a sore subject. Men stop bringing it up with the people around them. And because those conversations go hand in hand with self-care, the silence may leave men managing the disease more on their own.

The pattern was specific to healthcare. Men who reported more discrimination in everyday life, outside the doctor’s office, talked more about everything, including their diabetes.

More talk is not automatically better. The study found that more frequent communication overall, including about diabetes, was associated with worse mental health. Prochnow noted that diabetes conversations can come with pressure, nagging and fear.

What helped was the right kind of support. Men whose circles included more people they saw as truly supportive of their diabetes reported better mental health and better self-care.

“The practical message is volume is not always the lever,” Prochnow said. “Even one person who is genuinely in it with a patient appears to be worth more than a large circle of people.”

The researchers, who also include Ledric Sherman and Meg Patterson of Texas A&M and Matthew Lee Smith of the Indiana University School of Public Health, stress that the findings show associations, not proof that one thing causes another.

For doctors and health systems, the takeaway is to focus on respectful, culturally responsive care and communication rather than simply pushing for more contact. “The burden should not be on these men to fix a system that is failing them,” Prochnow said.

For Black men managing diabetes, the study is a reminder that how you are treated in the exam room can follow you home, and that one person truly in your corner can make a real difference.

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