The buffering effect of social support on diabetes distress and depressive symptoms in adults with Type 1 and Type 2 diabetes

Diabet Med. 2021 Apr;38(4):e14472. doi: 10.1111/dme.14472. Epub 2020 Dec 9.

Abstract

Background: Social support may buffer or decrease the negative effects of diabetes distress (DD) and depressive symptoms on diabetes outcomes. We assessed the buffering role of social support in the relationship between DD and self-care and depressive symptoms and self-care in adults with Type 1 (T1D) and Type 2 (T2D) diabetes.

Methods: Participants completed the Diabetes Distress Scale for T2D or T1D, the Patient Health Questionnaire-9, the Medical Outcomes Study Social Support Survey and the Self-Care Inventory-Revised. We conducted hierarchical multiple regression models using SPSS version 26.0.

Results: A total of 325 adults (median age = 40.5 years, 62.2% women, 86.5% White; 59.7% T2D, A1C = 59 ± 6 mmol/mol or 7.5 ± 1.6%; median duration = 11.0 years) participated. Greater social support buffered the negative effects of DD on self-care (R2 Δ = 0.015, p = 0.024) as well as depressive symptoms on self-care (R2 Δ = 0.024, p = 0.004) in participants with T1D and T2D. Both regression models recorded medium effect sizes (F2 = 0.220, F2 = 0.234 respectively). Social support subscale analyses showed tangible support (R2 Δ = 0.016, p = 0.018) and affectionate support (R2 Δ = 0.016, p = 0.020) buffered DD and self-care, and emotional support (R2 Δ = 0.015, p = 0.022), tangible support (R2 Δ = 0.020, p = 0.009), affectionate support (R2 Δ = 0.025, p = 0.004) and positive interaction support (R2 Δ = 0.017, p = 0.018) buffered depressive symptoms and self-care.

Conclusions: Findings suggest that social support buffers the impact of DD and depressive symptoms on self-care in adults with T1D and T2D. Additional research is needed to confirm the buffering role of social support on DD and depressive symptoms. Greater understanding of these interactions may help improve clinical care and outcomes.

Keywords: Type 1 diabetes; Type 2 diabetes; depression; diabetes distress; diabetes self-Care; social support.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Depression / epidemiology
  • Depression / prevention & control*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / psychology*
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Humans
  • Male
  • Psychological Distress
  • Psychosocial Functioning
  • Self Care / psychology
  • Self Care / standards
  • Self Care / statistics & numerical data
  • Social Support / psychology*
  • Stress, Psychological / epidemiology
  • Stress, Psychological / prevention & control*
  • Surveys and Questionnaires
  • United States / epidemiology