This study aimed to examine the associations among complication risk perception, gender role stress, and symptom management self-efficacy in patients with Type 2 diabetes mellitus and to identify factors associated with these constructs.

This analytical cross-sectional study was performed at the endocrinology outpatient clinic of a hospital. The sample consisted of 500 Type 2 DM patients (250 women, 250 men). Study data were gathered through the Individual Information Form (IIF), Risk Perception Survey–Diabetes Mellitus Scale (RPS-DM), Symptom Management Scale for Self-Efficacy (SMSSE), Feminine Gender Role Stress Scale (FGRSS), and Masculine Gender Role Stress Scale (MGRSS). The data were analyzed using the Mann–Whitney test, Kruskal–Wallis H test, Spearman correlation coefficients, and binary logistic regression.

It was determined that both in women and men, it was found that as gender role stress increased, composite and environmental risk perceptions increased, and symptom management self-efficacy decreased (p < 0.001). According to logistic regression analysis, when risk knowledge increases in women, self-efficacy will increase (OR: 0.595), and composite risk perception will decrease (OR: 7.377). When composite risk perception increases in men, self-efficacy will decrease (OR: 16.933).

Complication risk perception and gender role stress were associated with symptom management self-efficacy among patients with Type 2 DM, with these associations differing by sex. Future interventional studies are needed to determine whether addressing these factors improves symptom management for self-efficacy. The findings may also help nurses recognize sex-specific differences when planning individualized patient care.