Family Communication Central to Mothers' Type 2 Diabetes Self-Management

Introduction: How families function and provide support plays a central role in patients' self-management of Type 2 diabetes (T2DM) and prediabetes (preDM). Families would benefit from communication training, which is rarely incorporated into diabetes self-management education (DSME). Mothers are especially in need of this support. Women are at a higher risk of T2DM, and when mothers are patients, they can prioritize their family role and family's well-being over their personal needs as a patient. Method: To identify family communication that affects mothers' ability to self-manage T2DM/preDM, we interviewed 17 mothers aged 36-64 (M = 56). Transcripts were thematically analyzed. Results: Women described four family communication experiences affecting self-care: (a) family-of-origin communication (e.g., weight/diet messages during childhood), (b) communal coping communication (e.g., adopting healthy behaviors as a family), (c) communication inhibiting communal coping (e.g., negative response to mothers' lifestyle changes), and (d) mothers taking the lead (e.g., leading conversations or communicating control over family's lifestyle decisions). Discussion: Findings highlight the need for a family systems approach to DSME. Communication from multiple bonds (e.g., spouse, children) and past familyof-origin experiences impact self-care. Communal coping (appraising diabetes as "our" problem) was critical to self-management as mothers struggled to balance their needs with family members' preferences/attitudes. When not supported, mothers who took the lead communicatively could facilitate communal coping or prioritize self-care needs. Findings can inform a family-centered approach to DSME that highlights the importance of communal coping, provides all members communication skills training, and addresses the need for mothers to prioritize personal well-being.