Social support is associated with better diabetes self-management behavior (SMB), yet interventions to increase family and friend support (FF support) have had inconsistent effects on SMB. Rosland and coworkers tested whether FF support differentially affects specific SMBs; they also compared the influence of support from health professionals and psychological factors on specific SMBs to that of FF support. The study involved a cross-sectional survey of people with diabetes recruited for a self-management intervention. One hundred sixty-four African-American and Latino adults with diabetes living in inner-city Detroit served as subjects. The results showed that for every unit increase in FF support for glucose monitoring, the adjusted odds ratio (AOR) of completing testing as recommended was 1.77. FF support was not associated with four other SMBs (taking medicines, following a meal plan, physical activity, checking feet). Support from non-physician health professionals was associated with checking feet and meal plan adherence. Diabetes self-efficacy was associated with testing sugar, meal plan adherence, and checking feet. Additional analyses suggested that self-efficacy mediated the effect of FF support on diet and checking feet, but not the FF support effect on glucose monitoring.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDEER: The association between FF support and SMB performance was stronger for glucose monitoring than for other SMBs. Professional support and diabetes self-efficacy were each independently associated with performance of different SMBs. SMB interventions may need to differentially emphasize FF support, self-efficacy, or professional support depending on the SMB targeted for improvement.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The study not only reaffirmed the importance of self-management in the control of diabetes, but the significant role played by self-efficacy in fueling self-management performance. It is hoped that whatever self-management program you may enter will teach you the importance of self-efficacy in the performance and maintenance of self-management skills.

AM Rosland et al. When Is Social Support Important? The Association of Family Support and Professional Support with Specific Diabetes Self-management Behaviors. Journal of General Internal Medicine, October 15, 2008.