Young CF, Shubrook JH, Valencerina E, Wong S, Henry Lo SN, Dugan JA. Associations Between Social Support and Diabetes-Related Distress in People With Type 2 Diabetes Mellitus. J Am Osteopath Assoc 2020;120(11):721–731. doi: https://doi.org/10.7556/jaoa.2020.145.
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Diabetes is a complex, chronic condition and managing it can have psychosocial implications for patients, including an impact on relationships with their loved ones and physical wellness. The necessary modifications to daily behaviors can be very overwhelming, thus leading to diabetes-related distress.
To investigate the association between diabetes-related distress and perceived social support among people with type 2 diabetes.
This cross-sectional study surveyed a population with a lower socioeconomic status (Medi-Cal recipients, which are only given to low-income individuals) in Solano County, California. Patients who had type 2 diabetes mellitus, who were between 40 and 80 years old, and who had a medical appointment in the clinic(s) at least once between December 2015 and December 2016 were included. Patients who could not understand or speak English and patients whose primary care clinicians declined their participation in the study were excluded from the study. Each study participant was recruited at the end of their medical appointment, and the survey instrument in paper form was administered. The Problem Areas in Diabetes (PAID) scale, which indicates diabetes-related distress, and Multidimensional Scale of Perceived Social Support (MSPSS) with 3 subscales (family, friends, and significant others) were used in this study. Multiple linear regression models were used to analyze the associations between PAID and MSPSS surveys.
For the 101 participants included in our study, multiple linear regression models showed statistically significant association between total MSPSS scores and total PAID scores (β = −.318; 95% CI, .577, −.0581; P=.017) as well as between MSPSS family subscale scores and total PAID scores (β= −.761; 95% CI, −1.35, −.168; P=.012). Among the 3 MSPSS subscales, higher perceived support from family members was found to be significantly associated with lower total PAID scores (β= −.761; 95% CI, −1.35, −.168; P=.012).
Our findings suggest that a higher level of perceived social support experienced was associated with lower diabetes-related distress among patients with type 2 diabetes. Osteopathic physicians have a central role in providing comprehensive, patient-centered, holistic care, and the attention to social support in chronic disease management can help remove barriers in providing optimal care.
a Covariates included in this multiple linear regression model are age, HbA1c, SES, DCSI, ethnicity, and gender.
b PAID score=dependent variable; MSPSS or subscale=independent variable.
Abbreviations: DCSI, Diabetes Complications Severity Index; MSPSS, Multidimensional Scale of Perceived Social Support; PAID, Problem Ares in Diabetes; SES, socioeconomic status.
a Covariates included in this multiple linear regression model are age, SES, DCSI, ethnicity, and gender.
b H1bA1c=dependent variable; MSPSS or subscales=independent variable.
c DCSI=dependent variable; total MSPSS or subscales=independent variable.
d PAID=dependent variable; DCSI=independent variable.
Abbreviations: DCSI, Diabetes Complications Severity Index; MSPSS, Multidimensional Scale of Perceived Social Support; PAID, Problem Areas in Diabetes; SES, socioeconomic status.
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