A study of the relationship between social support, depression, alexithymia and glycemic control in patients with type 2 diabetes mellitus: a structural equation modeling approach

Social Support and Disease Acceptance in Patients with Diabetic Foot Syndrome and Their Relationship with the Metabolic Control of the Disease

Background: Diabetic foot syndrome (DFS) constitutes a serious clinical challenge in the treatment of diabetes. The aim of this study was to assess social support and acceptance of the disease in patients with diabetic foot syndrome and their relationship with the metabolic control of diabetes. Methods: This was an observational, single-center study, conducted in 80 people hospitalized in the general and vascular surgery department. This study included adult patients with type 1 or type 2 diabetes, diagnosed with DFS. The mean age of the patients was 65.63 years, with the median age of 62 years. The youngest patient was 27, and the oldest was 94 years old. Men constituted 71.25% of the study group, women 28.75%. The following data were collected: the results of laboratory tests and measurements, the Acceptance of Illness Scale (AIS), and the Social Support Scale (S4-MAD) scores. Results: Abnormal values of non-high-density lipoprotein cholesterol (mean (M) = 120.76 mg/dL) and low-density lipoprotein cholesterol (M = 144.56) were shown in all the patients. Abnormal low-density lipoprotein values occurred in 98.75% of the patients (M = 148.21 mg/dL), and 83.75% of the participants had abnormal values of the systolic pressure (M = 145 mmHg) and total cholesterol. Glycated hemoglobin was abnormal in 61.25% of the subjects (M = 8.95%). The average score on the Acceptance of Illness Scale was 18.4 points in the study group. Out of the 100 possible points in the subscales of social support, the patients obtained an average of 46.5 points in the nutrition dimension, 40 for physical activity, 47.1 for glycemic self-control, 27.4 for foot care, and 68.9 for smoking. Conclusions: Patients with diabetic foot syndrome are characterized by poor acceptance of the disease and receive moderate social support. Patients receive the highest support in terms of cigarette smoking and glycemic self-control, with the lowest in foot care. The patient's acceptance of the disease and the social support received are unrelated to the patient's goals of disease control. Higher social support received by the DFS patients is associated with a greater acceptance of the disease.