The social context of the relationship between glycemic control and depressive symptoms in type 2 diabetes.

Abstract

Individuals with type 2 diabetes and depressive symptoms have poorer diabetes outcomes than those with diabetes alone, and there is need for improved understanding of the relationship between illness markers and depressive symptoms. The role of social support is well established; less is known about social comparisons (i.e. comparisons to others in the social environment), which are common and influential in chronic illness. The present study examined the mediating effects of social comparison and social support on the relationship between glycemic control and depressive symptoms. Participants with physician-diagnosed type 2 diabetes (N = 185) completed an electronic survey about recent depressive symptoms, glycemic control (HbA1c), perceived social support, and social comparison. Controlling for relevant covariates, social comparison and social support showed independent statistical mediation of the relationship between glycemic control and depressive symptoms (ps < 0.05). Path analysis also showed that including indirect pathways through social comparison and social support reduced the relationship between glycemic control and depressive symptoms to nonsignificance (β = 0.10, p = 0.14). These findings demonstrate that social comparison plays a role in the relationship between diabetes regulation and depression, independent of social support. Greater attention to this aspect of the social environment may render better diabetes outcomes.