Family matters

Social support linked to success in managing diabetes, JAOA research suggests

Providing social support services for patients with Type 2 diabetes may improve care outcomes.


New research reveals a perceived lack of support from family and friends affects a patient’s ability to manage Type 2 diabetes, according to a study published in The Journal of the American Osteopathic Association. Among vulnerable populations, the necessary modifications to daily lifestyle can be difficult to maintain without adequate social support, leading to diabetes-related distress that derails treatment.

Diabetes distress refers to an emotional state characterized by feelings such as stress, guilt or denial that arise from living with diabetes and the burden of self-management.

Diabetes distress has been linked to worse health outcomes

Researchers found that as perceived social support increased, diabetes-related distress decreased. The scales used are established clinical tools that measure perceived social support and perceived distress related to diabetes.

“Too often diabetes treatment is understood as a simple process of taking medications and monitoring blood sugar,” says Clipper Young, PharmD, MPH, associate professor and a clinical pharmacist at Touro University California College of Osteopathic Medicine. “In reality, diabetes is a chronic condition that requires a great deal of mental and emotional energy, which, when depleted, can impair care.”

Diabetes-related mortality and morbidity are highest among people with lower socioeconomic status. Yet, few previous studies have investigated the nature of diabetes distress and social support pertaining to underserved, diverse populations with Type 2 diabetes.

The study was conducted at Solano County Family Health Services Clinics in Vallejo and Fairfield, California. Nearly 75% of the 101 study participants, who were between 40 and 80 years of age, reported an annual income of less than $20,000.

Integrate the family and support system into diabetes management

“Strong social support supplements effective diabetes self-management behaviors which, in turn, may reduce the risks of diabetes-related hospitalization and death,” says Young.

Given the significant role that social support has on diabetes-related distress, clinicians are highly encouraged to focus not only on providing medical care for people with diabetes but also on learning about their support system, Young notes.

“This research signals that our opening conversation with patients should include a robust assessment of diabetes-related distress and perceived social support,” says Young. “If that support is inadequate, we must think about how we can build it into the diabetes care plan.”

When working with a diabetes patient, providers should consider screening for diabetes distress, depression, anxiety and disordered eating, according to the American Diabetes Association, which also recommends assessing the patient’s cognitive capacities.

This should be done at the initial visit, at periodic intervals, and when there is a change in disease, treatment, or life circumstance. Including caregivers and family members in this assessment is recommended.

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