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Botchway M, Davis RE, Merchant AT, Appiah LT, Sarfo-Kantanka O, Moore S. Social networks, perceived social support, and HbA1c in individuals with type 2 diabetes mellitus in urban Ghana. ETHNICITY & HEALTH 2023; 28:281-298. [PMID: 35098827 DOI: 10.1080/13557858.2022.2033172] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Although links between social relationships and health are well established, few studies have concurrently examined the effects of compositional, structural, and functional dimensions of social networks on glycemic (HbA1c) control in low- and middle-income countries such as Ghana. In these settings where informal social relationships are critical for access to resources, evaluating the links between social network characteristics, social support, and glycemic control may provide clarity about important relationships that facilitate the well-being of individuals with type 2 diabetes mellitus (T2DM). DESIGN In 2018, we conducted a hospital-based, cross-sectional survey of noninstitutionalized adults with T2DM in Ghana. Using data from 247 study participants, multivariable linear regression models were used to estimate associations between: 1) HbA1c and three social network characteristics (kin composition, household composition, and network density); 2) social support and the three social network characteristics; and 3) HbA1c and social support. We also examined gender differences in these associations and applied mediation techniques to determine if network characteristics operated through social support to affect HbA1c. RESULTS Findings indicated that higher kin composition and higher household composition were each significantly associated with increased social support. Neither social support nor social network characteristics were significantly related to HbA1c, and there were no gender differences in any of these associations. CONCLUSION Although family and household members were identified as important sources of social support for diabetes management, the ways in which they influence HbA1c control among Ghanaians require further investigation. Future studies can examine whether changes in social support over time, social support satisfaction, or other dimensions of social relationships improve T2DM outcomes in countries like Ghana.
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Affiliation(s)
- Marian Botchway
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
| | - Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Lambert T Appiah
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Spencer Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Health & Society Group, Wageningen University & Research, Wageningen, Netherlands
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El-Radad HM, Sayed Ahmed HA, Eldahshan NA. The relationship between self-care activities, social support, and glycemic control in primary healthcare patients with type 2 diabetes. Diabetol Int 2022; 14:65-75. [PMID: 35966954 PMCID: PMC9362383 DOI: 10.1007/s13340-022-00598-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023]
Abstract
Objective Egyptian studies in assessing the relationship between diabetes self-care, social support, and glycemic control in primary healthcare (PHC) are limited. Therefore, this study aimed to assess this relationship, and to evaluate the associated factors of diabetes self-care, social support, and glycemic control in Egyptian PHC patients with type 2 diabetes (T2DM). Methods A cross-sectional study was conducted on 320 T2DM patients at four PHC settings in Port Said city, affiliated with the General Authority of Healthcare. A semi-structured questionnaire was used to collect data, including demographic characteristics, socioeconomic status scale, disease profile, the Arabic versions of the Summary of Diabetes Self-Care Activities, and the received social support scales. Data were collected from January 2020 to June 2020. Results Diabetes self-care activities, and self-monitoring of blood glucose had a very weak negative correlations with glycated hemoglobin (HbA1c) levels (rho = - 0.125, p = 0.025, rho = - 0.112, p = 0.044, respectively). Receiving social support on following a meal correlated positively and very weakly with HbA1c levels (rho = 0.145, p = 0.010). Hardly positive correlation was found between receiving emotional support on feelings about diabetes, and following a specific diet (rho = 0.169, p = 0.002). Diabetes self-care activities were positively associated with higher education levels, and elevated BMI. Received social support was negatively associated with having coronary artery disease, and marital status e.g. divorced and widow. Increased age, and female gender were the predictors of good glycemic control. Conclusion Diabetes self-care activities were linked with reduced HBA1c levels. Further studies are needed to evaluate the buffering effect of social support on glycemic outcomes in PHC patients with T2DM.
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Affiliation(s)
| | - Hazem A. Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nahed Amen Eldahshan
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Irony A, Magnezi R, Vilensky Sela Y. Self-Efficacy Effects of Maccabi Telcare Center Diabetes Mellitus Intervention: Do Men and Women Benefit Equally? Res Theory Nurs Pract 2021; 35:RTNP-D-20-00083. [PMID: 34162759 DOI: 10.1891/rtnp-d-20-00083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE A growing body of evidence points to physiological and psychological gender differences in the manifestation and treatment of type 2 diabetes mellitus. This study is part of a large-scale, prospective trial investigating the effects of Maccabi Telecare Center (MTC) interventions on self-efficacy. Here, we focus on the effects of gender on diabetes self-efficacy related to depressive symptom severity and illness representation. METHODS A prospective open-label study investigating the effect of tele-based intervention on diabetes self-efficacy. Participants completed the following questionnaires: Diabetes Management Self-Efficacy Scale (DMSES) (self-efficacy), Patient Health Questionnaire 9 (PHQ-9) (depression), and Illness Perception Questionnaire-Revised (IPQ-R) (illness representation). Data were collected at three time points: Baseline (T1), 3-4 months (T2), and 8-9 months (T3). RESULTS Although men and women exhibited similar baseline self-efficacy levels, men scored significantly higher than women over time, at T2 (p < .05) and T3 (p < .05). Consistent gender differences were observed throughout the study in depression and illness representations: women scored higher than men on PHQ-9 (3.94 vs. 5.57, p < .001), and perceived their diabetes consequences as more severe than men (p < .001). A linear regression analyses indicated that MTC intervention, age, baseline self-efficacy, and depression at T3 explained 39.8% of the variance of selfefficacy at the conclusion of the study for both genders, although more strongly for men. IMPLICATIONS FOR PRACTICE This study indicates that the effects of a treatment intervention for individuals with type 2 diabetes mellitus are gender specific. Thus, gender-tailored interventions may be advised to further improve outcomes for women with type 2 diabetes mellitus.
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Affiliation(s)
- Angela Irony
- Chief Nursing & Medical Centers Officer, Maccabi HealthCare Services Israel, Tel Aviv, Israel
| | - Racheli Magnezi
- Head of Public Health and Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
| | - Yael Vilensky Sela
- Department of Nursing, Faculty of Social and Community Science, Ruppin Academic Center, Emek-Hefer, Israel
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Sia HK, Kor CT, Tu ST, Liao PY, Chang YC. Predictors of treatment failure during the first year in newly diagnosed type 2 diabetes patients: a retrospective, observational study. PeerJ 2021; 9:e11005. [PMID: 33717708 PMCID: PMC7934644 DOI: 10.7717/peerj.11005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/02/2021] [Indexed: 12/21/2022] Open
Abstract
Background Diabetes patients who fail to achieve early glycemic control may increase the future risk of complications and mortality. The aim of the study was to identify factors that predict treatment failure (TF) during the first year in adults with newly diagnosed type 2 diabetes mellitus (T2DM). Methods This retrospective cohort study conducted at a medical center in Taiwan enrolled 4,282 eligible patients with newly diagnosed T2DM between 2002 and 2017. Data were collected from electronic medical records. TF was defined as the HbA1c value >7% at the end of 1-year observation. A subgroup analysis of 2,392 patients with baseline HbA1c ≥8% was performed. Multivariable logistic regression analysis using backward elimination was applied to establish prediction models. Results Of all study participants, 1,439 (33.6%) were classified as TF during the first year. For every 1% increase in baseline HbA1c, the risk of TF was 1.17 (95% CI 1.15–1.20) times higher. Patients with baseline HbA1c ≥8% had a higher rate of TF than those with HbA1c <8% (42.0 vs 23.0%, p < 0.001). Medication adherence, self-monitoring of blood glucose (SMBG), regular exercise, gender (men), non-insulin treatment, and enrollment during 2010–2017 predicted a significant lower risk of TF in both of the primary and subgroup models. Conclusions Newly diagnosed diabetes patients with baseline HbA1c ≥8% did have a much higher rate of TF during the first year. Subgroup analysis for them highlights the important predictors of TF, including medication adherence, performing SMBG, regular exercise, and gender, in achieving glycemic control.
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Affiliation(s)
- Hon-Ke Sia
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan.,Department of Healthcare Administration, Asia University, Taichung City, Taiwan
| | - Chew-Teng Kor
- Internal Medicine Research Center, Changhua Christian Hospital, Changhua City, Taiwan
| | - Shih-Te Tu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Pei-Yung Liao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Yu-Chia Chang
- Department of Healthcare Administration, Asia University, Taichung City, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung City, Taiwan
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Jaafaripooyan E, Habebo TT, Mosadeghrad AM, Foroushani AR, Anshebo DG. The Magnitude, Types, and Roles of Social Support in Diabetes Management among Diabetics' in Southern Ethiopia: a Multilevel, Multicenter Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:4307-4319. [PMID: 34703263 PMCID: PMC8541842 DOI: 10.2147/dmso.s332900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Lifelong medical management is the main intervention to reduce diabetes-related morbidities and premature deaths; yet, social support can be a vital intervention to improve diabetics' health. Therefore, this study aimed to determine the magnitude, types, and role of social support in diabetes management in southern Ethiopia. METHODS A multi-stage systematic sampling was applied to recruit 634 adult diabetics from the three-tiered healthcare system in the region. We proportionally distributed the sample size between randomly selected ten health-care facilities across the hierarchy. Pretested questionnaires and checklist; Epi-Info, and SPSS software used for data collection; entry, and analyses, respectively, and the statistical significance was determined at a P-value ≤0.05. RESULTS A total of 240 females and 356 males completed the study, and the overall magnitude of the social support was 50.20% [95% CI: 46.19%, 54.21%], and it was categorized into non-material and material with 44.13% [95% CI: 40.14%, 48.12%] and 34.23% [95% CI: 30.42%, 38.04%] magnitudes, respectively, and social support was left to the patients' families and friends whereas formal institutions and the public sectors were rarely offering when the patients needed it. Though sex, educational level, and health-care hierarchy were not significantly associated with the social support, residence, some occupations, presence of diabetic family members, acute medical conditions, blood glucose level, compliance to medical follow-ups, treatment adherence, and taking anti-diabetic drugs a day before the current visit to health-care facility were all statistically significantly associated with social support. CONCLUSION One of every two adult diabetic patients in southern Ethiopia was receiving any social support, and social support for diabetic people reduces medical follow-ups absenteeism, improves treatment adherence, glycemic level controlling, and helps lifestyle modifications. Therefore, to keep diabetic people healthy and achieve diabetes management goals, the Ethiopian healthcare system, institutions, and concerned stakeholders should strengthen the social support for diabetic patients.
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Affiliation(s)
- Ebrahim Jaafaripooyan
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran (the Islamic Republic)
| | - Teshome Tesfaye Habebo
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran (the Islamic Republic)
- Disease Prevention and Control Directorate, Kembata Tembaro Zone Health Department, Durame, SNNPRS, Ethiopia
- Correspondence: Teshome Tesfaye Habebo Email
| | - Ali Mohammad Mosadeghrad
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran (the Islamic Republic)
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran (the Islamic Republic)
| | - Dawit G/Michael Anshebo
- Public Health Emergency Management Directorate (PHEM), Kembata Tembaro Zone Health Department, Durame, SNNPRS, Ethiopia
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Optimism is associated with chronic kidney disease and rapid kidney function decline among African Americans in the Jackson Heart Study. J Psychosom Res 2020; 139:110267. [PMID: 33069050 PMCID: PMC7722009 DOI: 10.1016/j.jpsychores.2020.110267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/28/2020] [Accepted: 10/03/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Investigate the association of dispositional optimism with chronic kidney disease (CKD) and rapid kidney function decline (RKFD) and determine if there is modification by age, sex, and educational attainment among African Americans. METHODS Optimism was measured using the 6-item Life Orientation Test-Revised scale (categorized into tertiles and log transformed) among participants from the Jackson Heart Study (n = 1960). CKD was defined as the presence of albuminuria or reduced glomerular filtration rate of <60 mL/min/1.73m2, or report of dialysis at baseline examination (2000-2004). RKFD was defined as a decline >3 mL/min/1.73m2/year between baseline and exam 3 (2009-2013). The cross-sectional and prospective associations between optimism and kidney outcomes were tested using multivariable logistic regression to obtain odds ratios (OR) and 95% confidence intervals (CI), adjusting for demographics, education, risk factors, behaviors, and depressive symptoms. We tested effect modification by age, sex, and education. RESULTS 569 participants had CKD and 326 were classified as having RKFD by exam 3. After full adjustment, the OR for CKD was 0.73 for those who reported high (vs. low) optimism (95% CI 0.55-0.99) and 0.56 (95% CI 0.27-1.15) for the optimism score. After 7.21 median years of follow up, the OR for RKFD was 0.51 for those who reported high (vs. low) optimism (95% CI 0.34-0.76), and 0.26 (95% CI 0.10-0.56) for the optimism score, after full adjustment. There was no evidence of effect modification by demographics or educational attainment. CONCLUSIONS Higher optimism was associated with a lower odds of CKD and a lower odds of RKFD.
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Woods SB, Bridges K, Carpenter EN. The Critical Need to Recognize That Families Matter for Adult Health: A Systematic Review of the Literature. FAMILY PROCESS 2020; 59:1608-1626. [PMID: 31747478 DOI: 10.1111/famp.12505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A systemic approach to researching families and health should capture the complex network within which family members are embedded, including multiple family relationships and larger systems of health care. However, much of the families and health research focused on adult family members has focused solely on intimate partnerships, usually the marital relationship. This neglects the remainder of the powerfully influencing family relationships adults retain, and may increasingly focus on as they age. We conducted a systematic review of the families and adult health literature, retaining 72 articles which were subsequently thematically coded to highlight main foci of this area of research. Results highlight six themes, which include family relationship quality, family composition, behavioral factors in health and health care, psychophysiological mediators, caregiving, and aging health. Findings support an underrepresentation of family members, other than the intimate partner, in research on adult health.
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Affiliation(s)
- Sarah B Woods
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Kate Bridges
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX
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Celik A, Forde R, Sturt J. The impact of online self-management interventions on midlife adults with type 2 diabetes: a systematic review. ACTA ACUST UNITED AC 2020; 29:266-272. [DOI: 10.12968/bjon.2020.29.5.266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Online self-management education programmes are now recommended for people with type 2 diabetes to improve self-management capacities. There is limited evidence to determine whether such programmes improve the health outcomes for midlife adults with diabetes. Aims: The purpose of this systematic review was to assess the impact of online self-management interventions with digital consulting on glycated haemoglobin (HbA1c), total cholesterol, blood pressure, diabetes distress, self-efficacy, and depression in midlife adults. Methods: A systematic review was undertaken searching Medline, Embase and CINAHL. Studies were appraised using the Cochrane Collaboration's tool. Results: Eight studies were included. Online interventions resulted in the improvement of HbA1c (pooled mean difference on HbA1c: -0.35%, 95% CI (-0.52, -0.18), P<0.001). A narrative synthesis was conducted for all secondary outcomes. No conclusions could be drawn on the impact of these outcomes. Conclusion: Online interventions improve HbA1c. Further research is needed for secondary outcomes.
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Affiliation(s)
- Aycan Celik
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Rita Forde
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
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Kaya UP, Caydam OD. Association between Social Support and Diabetes Burden among Elderly Patients with Diabetes: A Cross-Sectional Study from Turkey. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2019; 7:86-92. [PMID: 31080388 PMCID: PMC6503691 DOI: 10.4103/sjmms.sjmms_44_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Elderly patients with diabetes receiving social support are likely to have better compliance with their disease self-care. However, no previous study from Turkey has assessed the effect of social support on diabetes burden among elderly patients. OBJECTIVE The objective of this study was to assess the association between social support and disease burden among elderly patients with diabetes in Turkey. MATERIALS AND METHODS This cross-sectional study included 271 randomly selected elderly patients with diabetes who presented to the internal medicine and diabetes polyclinics of three state hospitals (Sindirgi State Hospital, Balikesir Ataturk State Hospital and Balikesir State Hospital) in Balikesir, Turkey, between April and November 2017. A single interviewer collected all data using a sociodemographic form, the Elderly Diabetes Burden Scale (EDBS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Data were analyzed using arithmetic averages, percentages and Pearson's correlation. RESULTS The mean age of the participants was 72 ± 5.2 (65-88) years, and most (53.6%) were females and lived with their family: spouse (58.3%), children (18.5%) or both (17.7%). The mean EDBS score was 35.21 ± 6.94 (25-69), and the mean MSPSS score was 67.81 ± 17.33 (12-112). A significant negative correlation was found between the mean total of both assessment tools (P < 0.05), indicating diabetes burden was higher among those with lower social support. A similar significant correlation was observed between symptom burden, social burden, burden of dietary restrictions, burden by tablets or insulin and the total EDBS score. CONCLUSION This study found that in Balikesir, Turkey, social support for elderly patients with diabetes was mostly provided by their families and that their diabetes burden decreased with increased social support levels.
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Affiliation(s)
- Ummuhan Pinar Kaya
- Department of Internal Medicine, Sindirgi Balikesir State Hospital, Balikesir, Turkey
| | - Ozden Dedeli Caydam
- Department of Internal Medicine, Sindirgi Balikesir State Hospital, Balikesir, Turkey
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Glover LM, Bertoni AG, Golden SH, Baltrus P, Min YI, Carnethon MR, Taylor H, Sims M. Sex differences in the association of psychosocial resources with prevalent type 2 diabetes among African Americans: The Jackson Heart Study. J Diabetes Complications 2019; 33:113-117. [PMID: 30545559 PMCID: PMC6554648 DOI: 10.1016/j.jdiacomp.2018.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 11/07/2018] [Accepted: 11/14/2018] [Indexed: 11/21/2022]
Abstract
AIM To examine the association of psychosocial resources with prevalent type 2 diabetes (T2D) in 5104 African American men and women. METHODS Using data from the Jackson Heart Study (JHS), we evaluated the cross-sectional associations of four psychosocial resources (social support, optimism, religiosity, and social networks) with T2D [fasting glucose ≥126 mg/dL, or HbA1c ≥ 6.5%, or use of diabetic medication]. Multivariable Poisson regression estimated prevalence ratios (PR, 95% confidence interval-CI) of T2D by each psychosocial measure, adjusting for demographics, SES, waist circumference, health behaviors, and depressive symptoms. RESULTS Women reported greater religiosity and had more social networks than men (p < 0.001). High (vs. low) social support was associated with a lower prevalence of T2D among men after full adjustment (PR 0.74, 95% CI 0.59-0.91). Women with high (vs. low) social networks had a 16% lower prevalence of T2D (PR 0.84, 95% CI 0.73-0.96) after full adjustment. High (vs. low) optimism was associated with a 20% lower prevalence of T2D after adjustment for age (PR 0.80, 95% CI 0.65-0.98). Religiosity was not associated with T2D. CONCLUSION Social support and networks should be considered in efforts to prevent T2D among a high-risk group such as African Americans.
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Affiliation(s)
- LáShauntá M Glover
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sherita H Golden
- Department of Medicine and Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Peter Baltrus
- Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Yuan-I Min
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Herman Taylor
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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Braizat O, Feinn R, Abbott G, Wagner J. Relationship style and glycaemic control in women with type 2 diabetes: The mediating role of psychological distress. Stress Health 2018; 34:462-467. [PMID: 29327498 DOI: 10.1002/smi.2795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/29/2017] [Accepted: 11/30/2017] [Indexed: 11/09/2022]
Abstract
This study examined whether depressive symptoms and/or diabetes distress mediate the association between relationship style and glycaemic control in women with diabetes. Seventy-five women with type 2 diabetes completed the Relationship Questionnaire. Participants endorsing "secure" or "preoccupied" adult attachment were combined into the interactive relationship style and "dismissing/avoidant" or "fearful" adult attachment were combined into the independent relationship style. Glycaemic control was a latent variable composed of A1c and 48-hr continuously measured glucose. Diabetes distress was assessed with the Problem Areas in Diabetes scale and depressive symptoms with the Center for Epidemiological Studies Depression scale. A parallel multiple mediation model with relationship style as the independent variable, glycaemic control as the dependent variable, and Problem Areas in Diabetes and Center for Epidemiological Studies Depression scale as mediators, tested indirect effects. Bias-corrected bootstrap with 10,000 replications was used to construct 95% confidence intervals. The indirect association of relationship style with glycaemic control through diabetes distress was significant (effect = -0.09, p = .036, 95CI = -0.19-0.01), but through depressive symptoms was not. A model testing the indirect association of relationship style with diabetes distress through glycaemic control was not significant. Results suggest that relationship style is associated with glycaemic control through diabetes distress in women with type 2 diabetes.
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Affiliation(s)
| | - Richard Feinn
- Quinnipiac University Frank Netter School of Medicine, North Haven, CT, USA
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Mondesir FL, Carson AP, Durant RW, Lewis MW, Safford MM, Levitan EB. Association of functional and structural social support with medication adherence among individuals treated for coronary heart disease risk factors: Findings from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. PLoS One 2018; 13:e0198578. [PMID: 29949589 PMCID: PMC6021050 DOI: 10.1371/journal.pone.0198578] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/22/2018] [Indexed: 01/08/2023] Open
Abstract
Background Functional social support has a stronger association with medical treatment adherence than structural social support in several populations and disease conditions. Using a contemporary U.S. population of adults treated with medications for coronary heart disease (CHD) risk factors, the association between social support and medication adherence was examined. Methods We included 17,113 black and white men and women with CHD or CHD risk factors aged ≥45 years recruited 2003–2007 from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Participants reported their perceived social support (structural social support: being partnered, number of close friends, number of close relatives, and number of other adults in household; functional social support: having a caregiver in case of sickness or disability; combination of structural and functional social support: number of close friends or relatives seen at least monthly). Medication adherence was assessed using a 4-item scale. Multi-variable adjusted Poisson regression models were used to calculate prevalence ratios (PR) for the association between social support and medication adherence. Results Prevalence of medication adherence was 68.9%. Participants who saw >10 close friends or relatives at least monthly had higher prevalence of medication adherence (PR = 1.06; 95% CI: 1.00, 1.11) than those who saw ≤3 per month. Having a caregiver in case of sickness or disability, being partnered, number of close friends, number of close relatives, and number of other adults in household were not associated with medication adherence after adjusting for covariates. Conclusions Seeing multiple friends and relatives was associated with better medication adherence among individuals with CHD risk factors. Increasing social support with combined structural and functional components may help support medication adherence.
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Affiliation(s)
- Favel L. Mondesir
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - April P. Carson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Raegan W. Durant
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Marquita W. Lewis
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Monika M. Safford
- Department of Medicine, Weill Cornell Medicine, New York, New York, United States of America
| | - Emily B. Levitan
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- * E-mail:
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Acevedo-Negrete AP, Porchia LM, Gonzalez-Mejia ME, Torres-Rasgado E, Solis-Cano DG, Ruiz-Vivanco G, Pérez-Fuentes R. The impact of parental history of type 2 diabetes on hyperinsulinemia and insulin resistance in subjects from central Mexico. Diabetes Metab Syndr 2017; 11 Suppl 2:S895-S900. [PMID: 28697997 DOI: 10.1016/j.dsx.2017.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/01/2017] [Indexed: 01/16/2023]
Abstract
AIMS Hyperinsulinemia and insulin resistance are both associated with the development of Type 2 Diabetes and other pathologies; however, the influence of parental history of Type 2 diabetes (PH-T2D) has yet to be investigated. Therefore, this study was conducted to determine the effect of PH-T2D has on the risk of developing hyperinsulinemia and IR. MATERIALS AND METHODS 1092 subjects (703 non-pregnant females and 389 males) were enrolled for a cross-sectional study. Clinical and biochemical parameters were collected. Subjects were allocated according to their PH-T2D: no parents, one parent, or both parents. Insulin resistance was calculated using the HOMA1 equation (HOMA1-IR). Logistic regression was used to determine the association (odds ratio) between PH-T2D and hyperinsulinemia or insulin resistance. RESULTS Increasing degrees of PH-T2D were associated with significant increases in fasting plasma glucose, insulin, and HOMA1-IR (p <0.05). Subjects having one or both parents were associated with an increase risk of developing hyperinsulinemia (odds ratio=1.53, 95%CI: 1.12-2.09, and odds ratio=1.92, 95%CI: 1.21-3.06, respectively) and insulin resistance (odds ratio=1.47, 95%CI: 1.08-2.00 and odds ratio=1.77, 95%CI: 1.09-2.87, respectively), when adjusting for age, sex, BMI, fasting plasma glucose, and triglycerides. CONCLUSION The presences of PH-T2D significantly increased the risk of developing hyperinsulinemia and insulin resistance.
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Affiliation(s)
- Ana Paula Acevedo-Negrete
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, IMSS, Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Pue, Mexico
| | - Leonardo M Porchia
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, IMSS, Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Pue, Mexico
| | - M Elba Gonzalez-Mejia
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Pue, Mexico
| | - Enrique Torres-Rasgado
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Pue, Mexico
| | - Dania G Solis-Cano
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, IMSS, Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Pue, Mexico
| | - Guadalupe Ruiz-Vivanco
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, IMSS, Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Pue, Mexico; Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Pue, Mexico
| | - Ricardo Pérez-Fuentes
- Laboratorio de Investigación en Fisiopatología de Enfermedades Crónicas, Centro de Investigación Biomédica de Oriente, IMSS, Carretera Federal Atlixco-Metepec Km 4.5, C.P. 42730 Atlixco, Pue, Mexico; Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Calle 13 Sur 2901 Colonia Volcanes, C.P. 72000, Puebla, Pue, Mexico.
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Shao Y, Liang L, Shi L, Wan C, Yu S. The Effect of Social Support on Glycemic Control in Patients with Type 2 Diabetes Mellitus: The Mediating Roles of Self-Efficacy and Adherence. J Diabetes Res 2017; 2017:2804178. [PMID: 28626769 PMCID: PMC5463190 DOI: 10.1155/2017/2804178] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Ample evidence suggests that social support, self-efficacy, and adherence significantly, independently, and together affect glycemic control in patients with type 2 diabetes mellitus (T2DM), but the pathway from social support to glycemic control remains unclear. This study hypothesized that the effect of social support on glycemic control was mediated sequentially by self-efficacy and adherence. Patients with T2DM were recruited from two hospitals in Guangzhou, China, from January 1 to July 31, 2014, and their sociodemographic clinical data and their assessments on social support, self-efficacy, and adherence were obtained from medical records and self-completed questionnaires. Of the 532 patients who participated, 35% achieved glycemic control (i.e., HbA1c < 7%). Social support, self-efficacy, and adherence had significant correlations with each other and with glycemic control (P < 0.05). Regression analyses and structural equation modeling showed that better social support was associated to better patient self-efficacy, which, in turn, was associated with better medical adherence, which was associated with improved glycemic control, and the relationship between social support and glycemic control was sequentially and completely mediated by self-efficacy and adherence. The five goodness-of-fit indices confirmed that our data fitted the hypothesized pathway model strongly.
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Affiliation(s)
- Yechang Shao
- Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Lu Liang
- Division of Life Science, Center for Cancer Research, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Linjing Shi
- Division of Life Science, Center for Cancer Research, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Chengsong Wan
- School of Public Health, Southern Medical University, Guangzhou, China
- *Chengsong Wan:
| | - Shouyi Yu
- School of Public Health, Southern Medical University, Guangzhou, China
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Gonzalez-Zacarias AA, Mavarez-Martinez A, Arias-Morales CE, Stoicea N, Rogers B. Impact of Demographic, Socioeconomic, and Psychological Factors on Glycemic Self-Management in Adults with Type 2 Diabetes Mellitus. Front Public Health 2016; 4:195. [PMID: 27672634 PMCID: PMC5018496 DOI: 10.3389/fpubh.2016.00195] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/29/2016] [Indexed: 01/27/2023] Open
Abstract
Diabetes mellitus (DM) is reported as one of the most complex chronic diseases worldwide. In the United States, Type 2 DM (T2DM) is the seventh leading cause of morbidity and mortality. Individuals with diabetes require lifelong personal care to reduce the possibility of developing long-term complications. A good knowledge of diabetes risk factors, including obesity, dyslipidemia, hypertension, family history of DM, and sedentary lifestyle, play an essential role in prevention and treatment. Also, sociodemographic, economic, psychological, and environmental factors are directly and indirectly associated with diabetes control and health outcomes. Our review intends to analyze the interaction between demographics, knowledge, environment, and other diabetes-related factors based on an extended literature search, and to provide insight for improving glycemic control and reducing the incidence of chronic complications.
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Affiliation(s)
| | - Ana Mavarez-Martinez
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Carlos E Arias-Morales
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Nicoleta Stoicea
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Barbara Rogers
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
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