Glycemic control among Latinos with type 2 diabetes: the role of social-environmental support resources

Health Psychol. 2011 May;30(3):251-8. doi: 10.1037/a0022850.

Abstract

Objective: Although active diabetes self-management is required to achieve glycemic control, adherence is poor among ethnic minorities, especially Latinos. Research shows that individuals who report greater social-environmental support resources for disease management manage their diabetes more effectively than those with fewer support resources.

Methods: Path analysis was conducted to investigate the value of a multiple-mediator model in explaining how support resources for disease management influence hemoglobin A1c (HbA1c) levels in a sample of 208 Latinos with Type 2 diabetes recruited from low-income serving community clinics in San Diego County. We hypothesized that the relationship between support resources for disease-management and HbA1c would be mediated by diabetes self-management and/or depression.

Results: Participants who perceived greater support resources for disease-management reported better diabetes self-management (β = .40, p < .001) and less depression (β = -.19, p < .01). In turn, better diabetes self-management and less depression were associated with tighter glycemic control (HbA1c; β = -.17, p < .05 and β = .15, p < .05, respectively). Once the indirect effects via diabetes self-management (95% CI [-.25; -.03]) and depression (95% CI [-.14; -.01]) were statistically controlled, the direct pathway from support resources to HbA1c was markedly reduced (p = .57).

Conclusions: These findings demonstrate the important connection that support resources for disease management can have with diabetes self-management, emotional well-being, and glycemic control among Latinos. Thus, programs targeting diabetes self-management and glycemic control in this population should consider culturally relevant, multilevel influences on health outcomes.

MeSH terms

  • Adult
  • Aged
  • California
  • Depression / psychology
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Glycated Hemoglobin A / analysis
  • Hispanic Americans / psychology*
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Self Care / psychology
  • Social Environment
  • Social Support*
  • Socioeconomic Factors
  • Young Adult

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human