Diabetes distress in a Medicaid sample: The role of psychosocial and health-related factors

Social Needs and Type 2 Diabetes in Latinos: An Integrative Review

Type 2 diabetes (T2D) disparities in Latinos in the United States continue to rise despite ongoing efforts to advance health equity. Major drivers of T2D disparities are shaped by the social determinants of health which create unmet social needs such as unstable housing, unreliable transportation, food insecurity, financial need, and insufficient childcare. Latino communities are disproportionately affected by many social determinants of health and thus report disproportionately greater social needs than their Non-Hispanic White counterparts. As T2D prevalence, incidence, and associated complications in Latinos outpace those of Non-Latino Whites, an understanding of the potential influence of social needs on T2D prevention and management in this population is warranted. This integrative review describes the role of social needs in T2D prevention and management among Latinos. This review informs how certain social needs are associated with increased risk for T2D, prediabetes, and poor T2D self-management. Specific social needs interventions had mixed results in affecting T2D outcomes and social needs. There is a lack of research evaluating interventions with comprehensive social needs screen and referral for Latinos with or at risk for T2D across the lifespan.

The Impact of Hearing Loss on Diabetes Distress Among Adults With Type 2 Diabetes

PURPOSE

The purpose of this study was to assess the combined effects of type 2 diabetes (T2D) and hearing loss on the level of distress in individuals with diabetes.

METHODS

The 2021 National Health Interview Survey included 2633 adults (ages 18+) with T2D who reported perceived hearing loss, level of diabetes-related distress, household composition, and demographic characteristics. Logistic regressions evaluated these association between hearing loss and diabetes distress controlling for age, income, region of residence, marital status, rurality, educational attainment, insurance coverage, time since diabetes diagnosis, and household composition. Interaction effects examined differential associations between demographic groups.

RESULTS

About 3.5% of adults with T2D in the sample reported hearing loss, and 70% reported diabetes-related distress. Results indicated that diabetes distress was significantly more likely among individuals with hearing loss (OR = 2.08) relative to their hearing counterparts. Additionally, females (OR = 1.50), low-income earners (OR = 1.84), middle-income earners (OR = 1.41), non-Hispanic Blacks (OR = 1.58), and Hispanics (OR = 1.75) with diabetes had higher odds of reporting diabetes distress. Interaction analyses indicated that non-Hispanic Blacks and Hispanics with hearing loss had a 37% and 19%, respectively, higher likelihood of diabetes distress relative to non-Hispanic Whites with hearing loss.

CONCLUSION

Diabetes distress was more likely among individuals with hearing loss. These findings suggest the communication challenges of individuals with hearing loss may explain the observed differences in distress.

A Randomized Controlled Trial Testing the Effects of a Social Needs Navigation Intervention on Health Outcomes and Healthcare Utilization among Medicaid Members with Type 2 Diabetes

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (n = 239) or social needs navigation (n = 234) for 6 months and compare HbA1c (primary outcome), quality of life (secondary outcome), and other exploratory outcomes with t-tests and mixed-effects regression. Eligible participants had an HbA1c test in claims in the past 120 days and reported 1+ social needs. Data were collected from November 2019 to July 2023. Surveys were completed at baseline and at 3-, 6-, and 12-month follow-up. Health plan data included care management records and medical and pharmacy claims. The sample was from Louisiana, USA, M = 51.6 (SD = 9.5) years old, 76.1% female, 66.5% Black, 29.4% White, and 3.0% Hispanic. By design, more navigation (91.5%) vs. usual care (6.7%) participants had a care plan. Social needs persisted for both groups. No group differences in HbA1c tests and values were observed, though the large amount of missing HbA1c lab values reduced statistical power. No group differences were observed for other outcomes. Proactively eliciting and attempting to provide referrals and resources for social needs did not demonstrate significant health benefits or decrease healthcare utilization in this sample.

Psychological resilience mediates the relationship between diabetes distress and depression among persons with diabetes in a multi-group analysis

The aim to examine the link between diabetes distress and depression in individuals with diabetes, assess the mediating role of psychological resilience in this relationship, and analyses if these relationships differ between Type 1 and Type 2 diabetes. The study utilized a cross-sectional design. A total of 181 (age 33-72 years, mean = 54.76 years, and SD = 9.05 years) individuals diagnosed with diabetes who were receiving treatment from State Specialist Hospitals in Okitipupa were selected for the study using the convenient sampling technique. The data were analysed using Pearson Multiple correlation and multi-group mediation analysis. The analyses were carried out with Smartpls and IBM/SPSS Version 28.0. The results revealed a significant positive correlation between diabetes distress and depression (r = .80, p < .05), suggesting that higher levels of diabetes distress were associated with increased depression scores. Additionally, psychological resilience partially mediated the relationship between diabetes distress and depression (b = - 0.10, p < .05), signifying that resilience played a crucial role in mitigating the impact of diabetes distress on depression. Furthermore, a multi-group analysis was conducted to explore potential differences between Type 1 and Type 2 diabetes subgroups. The relationship between diabetes distress and depression was found to be more pronounced in the Type 1 subgroup (difference = 0.345, p < .05), while the relationship between psychological resilience and depression was negatively stronger in the Type 2 subgroup (difference = - 0.404, p < .05) compared to the Type 1 subgroup. There is an intricate linkage between diabetes distress, resilience, and depression, emphasizing the differential roles of resilience in Type 1 and Type 2 diabetes. The insights gleaned from this study underscore the importance of considering the type of diabetes when designing interventions and support mechanisms for individuals with diabetes who are also suffering from depression. By advancing our understanding of these dynamics, we can strive for more effective and personalized approaches to improve the overall well-being of those living with diabetes.

Advances in Psychological and Social Aetiology of Patients with Diabetes

Diabetes is a metabolic disease that is affected by internal and external factors. Its prevalence is rising, and it is characterized by a continuous increase in blood glucose levels. With the deepening understanding of diabetes, it is not only necessary to explore its physiological basis, but also to explore the complex interaction between social and psychological factors. In addition to traditional risk factors, the article also highlights the psychological and social aspects of the patient 's impact on the development of diabetes. Because diabetes is not only the result of metabolic imbalances, but also the product of broader background factors, the importance of psychosocial interventions is particularly important. By examining psychosocial dimensions, this review aims to provide a comprehensive understanding of the causes of diabetes. It deeply studies the complex relationship between psychosocial factors and diabetes, and recognizes the complexity of this metabolic disorder. In addition, the article discussed interventions designed to address the psychosocial problems of diabetes, emphasizing the need to take a holistic approach to care for patients. This review explores the impact of psychological and social factors on the incidence, progression and outcome of diabetes, complementing traditional considerations such as obesity, genetic and physiological factors. Recognizing the multifaceted nature of diabetes, this article uses a social etiology perspective to emphasize the important role of social psychological factors. In the process, it has contributed to the ongoing discussion on diabetes management by incorporating a broader social context into the understanding and treatment of this general health problem.