Abstract
Background: Social support is associated with better physical and mental health in people with diabetes. Social support may buffer the negative effects of diabetes distress on health outcomes. The purpose of this study was to assess the moderating role of social support in the relationship between diabetes distress and self-care in adults with type 1 (T1D) and type 2 (T2D) diabetes in Appalachian Ohio. Methods: Participants completed the Diabetes Distress Scale for T2D or T1D, the Medical Outcomes Study Social Support Survey, and the Self-Care Inventory Revised. We conducted hierarchical multiple regression models using SPSS version 26.0. To avoid multicollinearity with the interaction terms, variables were centered. Results: A total of 325 adults (age=41.6±19.2 years, 62.2% female, 86.5% white; A1C=7.5±1.6%; duration=12.4±9.6 years) participated. Of the 131 participants with T1D, 30.5% reported high diabetes distress. For the 194 T2D participants, 27.7% reported high diabetes distress. In the T1D model, diabetes distress and social support were significantly associated with diabetes self-care: R2 .15, F(2, 103)=8.81, p<.001. However, the interaction term did not account for the variance in T1D self-care (b= -.032, t= -.349, p=.728). In the T2D model, diabetes distress and social support were significantly associated with diabetes self-care: R2 .17, F(2, 182)=18.58, p<.001. The interaction term between diabetes distress and social support accounted for a significant proportion of the variance in T2D self-care: ΔR2=.03, ΔF(1, 296)=6.82, p=.01, b= -.185, t= -2.61, p=.01. Conclusions: Social support moderated the relationship between diabetes distress and self-care in adults with T2D but not T1D. Further explorations of social support in adults with T1D is warranted. Given the importance of kinship in Appalachian culture, engaging family members and the community in diabetes management may buffer the negative effect of diabetes distress. Disclosure E.A. Beverly: None. M.D. Ritholz: None. Funding American Osteopathic Association (1291708718)
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