The Role of Social Support in the Management of Type 2 Diabetes Mellitus among American Indians: A Qualitative Study.

The purpose of this study is to gain insights of American Indian (AI) communities on the role of social support in type 2 diabetes (T2D) management. Social support is a means of enhancing social and personal resources that can address underlying stressors that contribute to T2D inequities and represents a potential channel of intervention to improve management of T2D in these communities. This community-based participatory research included AI adults from the Bois Forte and Lac Courte Oreilles Bands of Ojibwe and consisted of focus groups that were conducted with people with T2D, social support persons, and service providers. Overall findings underscore the importance of social support in T2D management, especially in providing emotional support, fulfilling an appraisal function, and enabling positive health behaviors. It is also important for policies and practices to consider the social and cultural contexts, particularly the socio-historical context of life within AI communities that has inevitably shaped certain mindsets that may present barriers to care-seeking and optimal T2D management. These findings can inform interventions related to T2D management, especially in incorporating social support and complementing community strengths in achieving a broader goal of reducing diabetes inequities in AI communities.

A collaborative approach in patient education for diabetes foot and wound care: A pragmatic randomised controlled trial.

Foot care education is an important strategy in reducing lower limb complications. There is evidence that contemporary communication approaches can improve patient education outcomes. To inform the potential of such methods in diabetic foot education, we trialled a collaborative approach in patient education counselling in a podiatry clinic. We conducted a single-blind pragmatic randomised controlled trial on 52 diabetes patients who had an active foot ulcer. Participants were randomised to either collaborative education or traditional didactic education. Outcomes on knowledge and self-care behaviours were collected via a pre and post study questionnaire (max score: 75). The study ended at 12 weeks or when the wound healed prior. 42 (80.7%) participants completed the study. The collaborative patient education group had a significant increase in score post-study (38.8 ± 8.5) compared to pre-study (32.8 ± 6.9; P < .001). The control group had no significant increase in score post study. The difference in scores between groups had a moderate effect size (d = 0.54). The use of a collaborative approach in patient education was able to produce significantly greater increase in knowledge retention and self-care behaviours, without the need for additional consultation time in a podiatry clinic.