Perceptions of risks for diabetes‐related complications in Type 2 diabetes populations: a systematic review

Aim In Type 2 diabetes, there is no clear understanding of how people perceive their risk of experiencing diabetes‐related complications. To address this issue, we undertook an evidence‐based synthesis of how people with Type 2 diabetes perceive their risk of complications. Methods We performed a systematic search of nine electronic databases for peer‐reviewed articles published on or before 1 March 2016. Data from 18 studies reporting lay perceptions of risks for complications in Type 2 diabetes populations were included. Publication year ranged between 2002 and 2014. Results Methods used to assess risk perceptions were heterogeneous, ranging from questionnaires measuring the accuracy of perceived risks to semi‐structured and focus group interviews. We found evidence of low risk awareness in most dimensions of risk perceptions measured and the existence of optimistic bias. Conclusions Perceptions were generally biased and varied according to the dimension of risk measured, the subpopulation concerned and the type of complications considered. Future work is needed to identify the best practical ways of correcting for biased risk perceptions so as to encourage self‐care behaviours and treatment adherence. What's new? This systematic review is the first to provide an evidence‐based synthesis of risk perceptions for diabetes‐related complications in Type 2 diabetes populations. The review highlights the large heterogeneity in study designs and methods used to assess risk perceptions. Risk perceptions of people with Type 2 diabetes are generally biased, characterized by low risk awareness with most measurement methods and contaminated by optimistic bias. The specific biases identified in this review will help design more effective risk communication interventions.