Illness-related diabetes social support and glycemic control among middle aged and older adults

Objective: The objective of this study is to investigate the association between illness-related diabetes social support (IRDSS) and glycemic control (GC) among a racially diverse sample of middle aged and older adults. In gender-stratified models we examine whether the relationship between IRDSS and GC is modified by race/ethnicity. Additionally, we explore the association between eight individual types of IRDSS and GC. Methods: We used the Health and Retirement Study (HRS) 2002 and the 2003 Diabetes Survey. The final analytic sample consisted of 914 study respondents. Gender-stratified multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence intervals (CIs) for the association between IRDSS and GC, test an interaction between race/ethnicity and IRDSS, and investigate the association between individual IRDSS variables and GC. Final models were adjusted for socio-demographic characteristics, lifestyle factors and clinical characteristics. Results: 79.5% and 76.7% of males and females respectively are classified as having adequate glycemic control. Among females, there was a significant association between IRDSS and GC (OR: 2.39; 95% CI: 1.44, 4.00), but no significant association was observed among males. There was a significant interaction between race/ethnicity and IRDSS (p-value < 0.10). Among Hispanic females, there was a higher odds (OR: 5.75; 95% CI: 1.01, 32.63) of adequate glycemic control in those who had high levels of IRDSS. The strongest association was found between high levels of emotional oriented social support and GC among females (OR=2.05; 95% CI: 1.18, 3.54). Conclusion: Our findings suggest that the relationship between IRDSS and GC varied by gender, where we only observed an association among females. Although we found a significant interaction between Hispanic race/ethnicity and IRDSS among females, our results should be interpreted with caution due to small sample sizes for the groups. We found that type of social support for self-care activities may play a role in achieving GC, where emotional support was most important. Further studies should aim at identifying factors which may determine gender differences in the association between IRDSS and GC. Race/ethnicity as an effect modifier of this association also needs further exploration in studies with larger sample sizes.

Copyright - Copyright ProQuest, UMI Dissertations Publishing 2013 Last updated - 2014-01-21 First page - n/a

0766:Epidemiology

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