Diabetes Care and Its Association With Glycosylated Hemoglobin Level

Background: This article examines the associations between patients' source of most help with diabetes care and their glycosylated hemoglobin (A1C) levels. The extent to which differences in A1C by source of most help could be explained by perceived levels of total social support, sociodemographics, and medication adherence were also assessed. Methods: A cross-sectional study of 205 adults with type 2 diabetes mellitus who completed a clinic survey that included questions about perceived social support, who provides the most support with their diabetes care, and medication adherence. The most recent A1C was abstracted from medical records. Results: The mean (standard deviation) age of participants was 61 (12.3) years, 43.9% were male, 37.1% African American. After adjustment for age, sex, race, marital status, education, diabetes duration, and medication adherence, the means (95% confidence intervals) A1C by source of most help were 9.4 (8.4-10.4) for nonspouse family or friend, 8.2 (7.3-9.1) for health care worker, 8.2 (7.2-9.1) for self-reliant, and 8.1 (7.1-9.0) for spouse. A1C was significantly higher for nonspouse family or friend compared with all other groups (P < 0.01 for each comparison). Differences in A1C by source of most help could not be explained by differences in total social support or medication adherence. Conclusions: Patients reporting a nonspouse family member or friend as their source of most help with their diabetes management had worse glycemic control than patients reporting all other sources of help.