How well are people with diabetes being supported?

By Dr. Priyom Bose, Ph.D.Feb 16 2023Reviewed by Danielle Ellis, B.Sc.

A recent study published in the journal Patient Education and Counseling aimed to determine the mismatch between the actual support received and the desired level for diabetic patients. The study also evaluated this mismatch's impact on patients' health outcomes.

Study: Are people with diabetes getting the support they need? Deficits between support desired and received from family and friends relates to poorer health. Image Credit: Dragana Gordic / Shutterstock

Background

Social support has been seen to have mitigating effects on morbidity and mortality in managing chronic illnesses, such as diabetes. Self-management support empowers individuals to manage their illnesses to promote better health. Research has shown the beneficial effects of partner or spousal support, such as more physical activity. However, the preferences for actual social support are often ignored, creating mismatches between support needed and received. Individuals desire for support affects their psychological (e.g., anxiety and depression) and physical (e.g., self-care activities) well-being.

Research examining the implications of support mismatch in diabetic individuals is scarce. More work should be carried out to understand if the driver of poor biophysical and psychological health could be the mismatch between desired and received support.

About the Study

The first aim of the current study is to determine the level of support mismatch in diabetic patients. It also aims to analyze the relationship between support mismatch and biophysical and psychosocial health. The working hypothesis is that people with diabetes with greater support deficits will be worse off in terms of biophysical, psychosocial, and self-care health outcomes.

The study is cross-sectional and uses survey data and medical records of patients with Type 1 and Type 2 diabetes. Biophysical metrics included diastolic blood pressure, systolic blood pressure, body mass index, triglycerides, HbA1c, and high- and low-density lipoproteins.

The psychosocial and self-care survey outcomes included diabetes self-care, diabetes self-efficacy, and diabetes distress. Support mismatch was a difference score (i.e., support received subtracted from support desired). Descriptive statistics were computed for clinical characteristics, demographics, and primary outcomes. Multiple linear regressions were estimated.

Key Findings

About 42% to 52% of participants experienced support mismatch across six domains. Perceptions of support deficits in diabetes management were reported by 23% to 34% of the participants. Additionally, support deficits were correlated with poorer psychosocial and biophysical outcomes.

The reported support deficits were more significant in women and insulin-using participants. Support surpluses, i.e., receiving more support than needed, were unrelated to any key study outcomes. Individuals with greater support deficits reported more significant diabetes distress, higher triglyceride levels, and lower diabetes self-efficacy. These results accounted for demographic and clinical characteristics, thereby minimizing the role of confounders.

To ensure robustness, additional regressions were estimated controlling for insulin use. The results were similar to the aforementioned ones with one addition: higher support deficit correlated with higher BMI.

Taken together, the results highlight that diabetic patients with perceived support deficits could be at a higher risk of experiencing adverse biophysical and psychosocial health outcomes. The authors, therefore, stressed the alignment of desired and received support in diabetes management. Additionally, aligning with the dyadic coping concepts found in theoretical frameworks is also essential. 

This study contributes to the social support literature by focusing on mismatches rather than on perceived support. This aids in establishing the correlations between support deficits and support surpluses and the overall health outcomes in diabetic patients.

Conclusion

This study sheds light on the existence of the mismatch between the support that diabetic patients require and the actual support they receive. Additionally, the significant correlations between biophysical and psychosocial health and support deficits were examined in this paper. The results have implications for the appropriate design of intervention programs to ensure that diabetic patients receive high-quality and adequate support to manage the disease effectively.