Social Support Strategies in Adult Patients With Diabetes

A Review of Strategies in the USA and Europe

Julienne K Kirk; Christine N Ebert; Ginger P Gamble; C Edward Ebert


Expert Rev Endocrinol Metab. 2013;8(4):379-389. 

In This Article

Abstract and Introduction


Improvement of adherence in patients with a chronic disease state such as diabetes can be facilitated through well-crafted social support strategies. Family and friends are support options for many individuals living with diabetes. A systematic search of three databases was conducted to evaluate literature published from 2006 to April 2013 regarding social support in adults with diabetes conducted in the USA and Europe. While various studies had different findings, the overall trend shows that social support can result in a positive influence on both the ability of the patient to initiate and sustain diabetes management that can potentially result in positive health outcomes. This appears true even when the patient has low psychosocial skills and a small social support network. Healthcare professional involvement also correlates with patient improvement in specific outcomes not overlapped by the patient's social network. Support facilitated by peers can be a viable option along with the multitude of electronic options to help with social support.


A major challenge for patients with diabetes is adherence to self-care management regimens. The growing incidence of diabetes is becoming a worldwide epidemic and a recent systematic analysis indicates prevalence estimates have risen to 347 million people in 2008 and the disease has doubled over nearly the past three decades.[1] Diabetes is a chronic disease requiring individuals to self-manage multiple components of care. Many patients fail to consistently engage in self-care behaviors such as lifestyle modification, coping strategies, medication management, healthy nutrition, glucose monitoring, regular activity and reducing risks that are necessary for positive health outcomes.[2] Support systems that include the involvement of family and friends can often play a positive role in the encouragement of individuals to adhere to often complex regimens.

A systematic review of controlled, intervention studies was conducted and published in 2005 by van Dam et al. evaluating social support in diabetes. The the authors recognized that social support can include emotional, appraisal, informational and tangible assistance.[3] There are various aspects of care that can encompass social support but usually the term involves the concept of coping. A basic definition of social support is as follows: 'an exchange of resources between at least two persons aimed at increasing the wellbeing of the receiver'.[4] This review examines current aspects of patient social support with an ultimate goal toward evaluating the role of family and friends as support mechanisms for adult patients with diabetes in the developing world. Since social support can also include other forms of contact with peers and the use of a wide array of technology, the utility of these resources will also be addressed. Peer support and technology options (phone, internet and other devices) are gaining increased use, so these areas of social support are included as a brief overview for comprehensiveness.