Out-of-home informal support important for medication adherence, diabetes distress, hemoglobin A1c among adults with type 2 diabetes

J Behav Med. 2019 Jun;42(3):493-501. doi: 10.1007/s10865-018-0002-0. Epub 2018 Dec 14.

Abstract

Adults with type 2 diabetes mellitus (T2DM) often receive self-management support from adult children, siblings or close friends residing outside of their home. However, the role of out-of-home support in patients' self-management and well-being is unclear. Patients (N = 313) with HbA1c > 7.5% were recruited from community primary care clinics for a mobile health intervention trial and identified an out-of-home informal support person, herein called a CarePartner; 38% also had an in-home supporter. We tested cross-sectional adjusted associations between CarePartner relationship characteristics and patients' self-management, diabetes distress, and HbA1c and whether having an in-home supporter modified these associations. Greater CarePartner closeness was associated with a greater odds of perfect medication adherence (AOR = 1.19, p = .029), more fruit/vegetable intake (β = 0.14, p = .018), and lower diabetes distress (β = - 0.14, p = .012). More frequent CarePartner contact was associated with better HbA1c among patients with an in-home supporter but with worse HbA1c among patients without an in-home supporter (interaction β = - 0.45, p = .005). Emotional closeness with a CarePartner may be important for supporting T2DM self-management and reducing diabetes distress. CarePartners may appropriately engage more frequently when patients with no in-home supporter have poorly controlled diabetes.

Keywords: Disease self-management; Family; Glycemic control; Informal caregivers; Social support; Type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Adult Children
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / psychology
  • Family Relations
  • Female
  • Glycated Hemoglobin*
  • Humans
  • Internal-External Control*
  • Male
  • Medication Adherence* / psychology
  • Middle Aged
  • Self Care* / psychology
  • Self-Management
  • Social Support
  • Telemedicine* / methods

Substances

  • Glycated Hemoglobin