Effect of social networks intervention in type 2 diabetes: a partial randomised study The impact of a social network based intervention on self-management behaviours among patients with type 2 diabetes living in socioeconomically deprived neighbourhoods: a mixed methods approach Social support and personal models of diabetes as predictors of self-care and well-being: a longitudinal study of adolescents with diabetes. Long-term effects of the Mediterranean lifestyle program: a randomized clinical trial for postmenopausal women with type 2 diabetes How does change occur following a theoretically based self-management intervention for type 2 diabetes Self-Efficacy, Problem Solving, and Social-Environmental Support Are Associated With Diabetes Self-Management Behaviors Text message-based diabetes self-management support (SMS4BG): study protocol for a randomised controlled trial Enhancing support for health behavior change among women at risk for heart disease: the Mediterranean Lifestyle Trial. Social Support Groups in the Maintenance of Glycemic Control after Community-Based Intervention Relationship between social support and the physical and mental wellbeing of older Mexican adults with diabetes. Stages of change for healthy eating in diabetes: relation to demographic, eating-related, health care utilization, and psychosocial factors. Diabetes support groups improve health care of older diabetic patients. Diabetes Learning in Virtual Environments: Testing the Efficacy of Self-Management Training and Support in Virtual Environments (Randomized Controlled Trial Protocol). Cardiovascular Risk Education and Social Support (CaRESS): Report of a Randomized Controlled Trial from the Kentucky Ambulatory Network (KAN) Do pre-existing diabetes social support or depressive symptoms influence the effectiveness of a diabetes management intervention? Social factors and barriers to self-care adherence in Hispanic men and women with diabetes. The Contribution of Social Networks to the Health and Self-Management of Patients with Long-Term Conditions: A Longitudinal Study Outcomes from a Multiple Risk Factor Diabetes Self-Management Trial for Latinas: ¡Viva Bien!
Background In this partially r and omised intervention study , we assessed the effect of social networks on the improvement of  type 2 diabetes management  in a largely African – American population in Baltimore . Methods Patients in the intervention group ( n=68 ) were asked to recruit peers , form small groups , and attend monthly diabetes education sessions , emphasising peer support .  Patients in the control group ( n=70 ) were recruited individually to attend st and ard diabetes education sessions . The primary outcomes were changes in haemoglobin A1C ( HbA1c ) and blood glucose . Secondary outcomes included blood pressure , weight , functional status , self-efficacy , perceived cohesion , social network connectedness and diabetes knowledge . General linear mixed models were built to assess mean absolute changes in primary and secondary outcomes at 3 and 6 months . Results At 6 months from baseline , the social network intervention group achieved a larger reduction in HbA1c of −0.32 % ( p<0.0001 ) and blood glucose of −10.6 mg/dL , ( p<0.0001 ) compared to the control group . In analyses of secondary endpoints , the intervention group had more favourable outcomes over time for weight , quality of life , self-efficacy , social network scores and diabetes knowledge , compared to the control group . While blood pressure decreased , and perceived cohesion increased in both groups over the duration of the study , the difference between groups was not statistically significant . Conclusions The social networks intervention showed improved integration of patients within their existing networks leading to a greater reduction in HbA1c and blood glucose , as well as improved behaviour mediating outcomes Aims : This paper aims to explore the effect of the social network based intervention Powerful Together with Diabetes on diabetes self-management among socioeconomically deprived patients . This 10-month group intervention targeting patients and significant others aim ed to improve self-management by stimulating social support and diminishing social influences that hinder self-management . Methods : This intervention was evaluated in a quasi-experimental study using a mixed methods approach . Of 131 socioeconomically deprived patients with suboptimal glycaemic control , 69 were assigned to the  intervention  group and 62 to the  control group ( st and ard diabetes education ) . 27 qualitative in-depth interviews with the participants and 24 with their group leaders were held to study the subjective impact of the intervention . Further , self-management behaviours ( medication adherence , diet and physical activity ) were assessed at baseline , 10 and 16 months . Data were analysed using framework analyses and a linear mixture model . Results : Qualitative data showed that the intervention group had a better underst and ing of the way self-management influences diabetes . The intervention group showed more complex self-management behaviours , such as planning ahead , seeking adequate food and physical activity alternatives , and consistently taking their diabetes into consideration when making choices . In participants with complete follow-up data , we found a significant increase in physical activity in the intervention group ( 3.78 vs. 4.83 days ) and no changes in medication adherence and diet . Conclusions : This study indicates that an intensive support group and simultaneously involving significant others might improve diabetes self-management behaviours among socioeconomically deprived patients . More studies are needed to justify further implementation of the intervention . This study is registered in the Dutch Trial Register NTR1886 . http://www.trialregister.nl/trialreg/admin/ rct OBJECTIVES To examine whether peer support and illness representation mediate the link between family support , self-management and well-being . METHOD Fifty-two adolescents ( 12 - 18 years old ) with Type I diabetes were recruited and followed over 6 months , completing assessment s of self-management , well-being , and social support . RESULTS Perceived impact of diabetes and supportive family and friends were prospect ively predictive of participants ' well-being measures . Although support from family and friends was predictive of better dietary self-care , this relationship was mediated by personal model beliefs . In particular , beliefs about the effectiveness of the diabetes treatment regimen to control diabetes was predictive of better dietary self-care . CONCLUSIONS Both friends and family are important to support adolescents as they live with and manage their diabetes . Personal models of diabetes are important determinants of both dietary self-care and well-being . In addition , personal models may serve to mediate the relationship between social support and dietary behavior Background Multiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors , psychosocial factors , and the social environment . This report examines the long-term effects of a multiple-risk-factor intervention . Methods Postmenopausal women ( N = 279 ) with type 2 diabetes participated in the  Mediterranean Lifestyle Program ( MLP ) , a r and omized , comprehensive lifestyle intervention study . The intervention targeted healthful eating , physical activity , stress management , smoking cessation , and social support . Outcomes included lifestyle behaviors ( i.e. , dietary intake , physical activity , stress management , smoking cessation ) , psychosocial variables ( e.g. , social support , problem solving , self-efficacy , depression , quality of life ) , and cost analyses at baseline , and 6 , 12 , and 24 months . Results MLP participants showed significant 12- and 24-month improvements in all targeted lifestyle behaviors with one exception ( there were too few smokers to analyze tobacco use effects ) , and in psychosocial measures of use of supportive re sources , problem solving , self-efficacy , and quality of life . Conclusion The MLP was more effective than usual care over 24 months in producing improvements on behavioral and psychosocial outcomes . Directions for future research include replication with other population The purpose of this study was to test the extent that constructs from two theoretical models ( self-regulatory theory and social cognitive theory ) mediated change in outcomes following a self-management intervention .  One hundred and twenty four individuals with type 2 diabetes who had participated in a r and omised controlled trial of a diabetes self-management programme  were analysed for the extent that illness beliefs and self-efficacy mediated change in self-management behaviours and illness specific quality of life . Exercise specific self-efficacy significantly mediated change in exercise  at three months ( B = .03 ; .01 , p < .05 ) while  monitoring specific self-efficacy mediated change in monitoring behaviour at both three ( B = .04 ; .01 , p < .01 ) and nine months follow-up ( B = 5.97 ; 1.01 , p < .01 ) . Belief in control over diabetes mediated change in illness specific quality of life at three months ( B = −.07 ; .28 , p < .05 ) and nine months ( B = .79 ; .28 , p < .01 ) follow-ups , as well as change in exercise behaviour at immediately post-intervention ( B = −.12 ; .17 , p < .05 ) . Behaviour-specific self-efficacy may have a stronger role in mediating self-management behaviours than illness beliefs ; however , belief in control over diabetes may be important to manipulate for change in quality of life . This suggests different theoretical constructs may mediate change dependent on outcome OBJECTIVE To evaluate associations between psychosocial and social-environmental variables and diabetes self-management , and diabetes control . RESEARCH DESIGN AND METHODS Baseline data from a type 2 diabetes self-management r and omized trial with 463 adults having elevated BMI ( M = 34.8 kg/m2 ) were used to investigate relations among demographic , psychosocial , and social-environmental variables ; dietary , exercise , and medication-taking behaviors ; and biologic outcomes . RESULTS Self-efficacy , problem solving , and social-environmental support were independently associated with diet and exercise  , increasing the variance accounted for by 23 and 19 % , respectively . Only diet contributed to explained variance in BMI ( β = −0.17 , P = 0.0003 ) and self-rated health status ( β = 0.25 , P < 0.0001 ) ; and only medication-taking behaviors contributed to lipid ratio ( total – to – HDL ) ( β = −0.20 , P = 0.0001 ) and A1C ( β = −0.21 , P < 0.0001 ) . CONCLUSIONS Interventions should focus on enhancing self-efficacy , problem solving , and social-environmental support to improve self-management of diabetes Background Addressing the increasing prevalence , and associated disease burden , of diabetes is a priority of health services internationally . Interventions to support patients to effectively self-manage their condition have the potential to reduce the risk of costly and debilitating complications . The utilisation of mobile phones to deliver self-management support allows for patient-centred care at the frequency and intensity that patients desire from outside the clinic environment . Self-Management Support for Blood Glucose ( SMS4BG ) is a novel text message-based intervention for supporting people with diabetes to improve self-management behaviours and achieve better glycaemic control and is tailored to individual patient preferences , demographics , clinical characteristics , and culture . This study aims to assess whether SMS4BG can improve glycaemic control in adults with poorly controlled diabetes . This paper outlines the rationale and methods of the trial . Methods / design A two-arm , parallel , r and omised controlled trial will be conducted across New Zeal and health districts . One thous and participants will be r and omised at a 1:1 ratio to receive SMS4BG , a theoretically based and individually tailored automated text message-based diabetes self-management support programme ( intervention ) in addition to usual care , or usual care alone ( control ) . The primary outcome is change in glycaemic control ( HbA1c ) at 9 months . Secondary outcomes include glycaemic control at 3 and 6 months , self-efficacy , self-care behaviours , diabetes distress , health-related quality of life , perceived social support , and illness perceptions . Cost information and healthcare utilisation will also be collected as well as intervention satisfaction and interaction . Discussion This study will provide information on the effectiveness of a text message-based self-management support tool for people with diabetes . If found to be effective it has the potential to provide individualised support to people with diabetes across New Zeal and ( and internationally ) , thus extending care outside the clinic environment . Trial registration Australian New Zeal and Clinical Trials Registry : ACTRN12614001232628 This paper describes a r and omized study to evaluate the effects of a comprehensive lifestyle management intervention for 279 postmenopausal women with type 2 diabetes who are at elevated risk for coronary heart disease ( CHD ) . The intervention , called the Mediterranean Lifestyle Trial , is focused on dietary factors , physical activity , social support and stress management . The Mediterranean Lifestyle Trial relies on a synthesis of Social Cognitive Theory and Social Ecologic Theory , as well as goal -systems theory , to explicitly inform the lifestyle intervention and to address maintenance . Thus , the trial should help illuminate the theoretical mechanisms responsible for lifestyle change . Primary outcome variables are dietary , stress management and physical activity behavior change , quality of life , and CHD-related biological risk factors . Hypothesized mediating variables include self-efficacy , coping , and social and environmental support . Following the initial 6-month intervention , participants in the intervention condition are r and omized to one of two groups design ed to enhance maintenance of effects : either a peer-led support group or a personalized multilevel community re sources maintenance condition . Unlike the peer group , the personalized approach focuses on multiple levels of community re sources to promote healthful lifestyle change . Because this research focuses on issues of generalization and translation to practice , the RE- AIM evaluation framework is being used to evaluate Reach , Effectiveness , Adoption , Implementation and Maintenance . This framework will help to translate research into practice by directing research ers ' attention to important but seldom-investigated strategies for enhancing longer-term maintenance . Specifically , the study tests how long-term maintenance may be improved through the use of existing community re sources , an intervention based on multiple environmental factors and multiple lifestyle behaviors , and lay leaders versus personalized professional support Native Hawaiians and other Pacific Isl and ers ( NH/PI ; e.g. , Samoan and Chuukese ) have higher type 2 diabetes prevalence compared to other groups in Hawai‘i . Partners in Care ( PIC ) , a culturally tailored , community-based , diabetes self-management education intervention ( DSME ) , is effective at improving participants ' glycemic control and self-care behaviors . Maintenance of improvements is challenging . Diabetes-related social support groups ( SSG ) are a promising maintenance component for DSME . This study examined the effects of a diabetes-specific SSG component relative to a control group , after the receipt of the 3-month PIC intervention , which was delivered to 47 adult NH/PI with type 2 diabetes . Participants were then r and omized to either a 3-month , 6-session SSG or a control group .  Hemoglobin A1c ( HbA1c ) , blood pressure , triglycerides , cholesterol , and diabetes self-management knowledge and behaviors were assessed at baseline , 3 months , and 6 months . Results indicated significant improvements in HbA1c , diabetes-related self-management knowledge , and behaviors from baseline to 3-month assessment . However , no differences between the SSG and control group from 3-month to 6-month assessment suggest that all participants were able to maintain initial improvements . The SSG group had a significant decrease in systolic blood pressure from 3-month to 6-month assessment while the control group did not . Study limitations and future directions are discussed OBJECTIVE To determine the relationship between social support and certain indicators of physical and mental wellbeing in older adults with type 2 diabetes . MATERIAL AND METHODS We undertook a population -based cross sectional study of 705 adults with type 2 diabetes from the Instituto Mexicano del Seguro Social ( IMSS ) . Participants were r and omly selected from a list of diabetic patients located in the south of Mexico City . Physical and mental wellbeing were assessed through three indicators : 1 ) Health related quality of life ( HRQL ) ; 2 ) depressive symptomatology , and 3 ) glycemic control . Level of social support level was determined using the The Social Support Health Survey instrument . Multiple linear regression models were used to analyze the independent association of social support with the physical and mental wellbeing indicators , controlling for progression time , diabetes complications , co-morbidity and socio-demographic variables . RESULTS High levels of social support were reported by 64 % of participants . Social support and HRQL increased in direct proportion : the more social support a participant reported the less depressive distress and better fasting glucose levels they showed . The results maintained their significance in the four social support subscales , with the exception of affectionate and emotional or informational support subscales , which were not significantly correlated with fasting glucose . Multiple linear regression analyses showed that better levels of social support are associated with improved HRQL ( beta = 0.12 ) , less incidence of depressive symptoms ( beta = -0.20 ) and lower fasting glucose ( beta = -0.10 ) . CONCLUSIONS Our findings suggest that greater levels of social support may improve certain indicators of physical and mental wellbeing in older adults with type 2 diabetes , regardless of the presence of diabetes complications and other chronic pathologies . Thus , promoting social support for the IMSS ' diabetic patients could be a useful intervention OBJECTIVES To identify diabetes-related characteristics of individuals at different stages of readiness to change to healthy ,  low-fat eating . RESEARCH DESIGN AND METHODS Stage-based differences in demographic , eating-related , health care utilization , and psychosocial factors were examined in a sample of 768 overweight ( BMI > 27 kg/m(2 ) ) individuals with diabetes enrolled in a r and omized behavioral intervention trial . RESULTS Stage-based differences occurred for type 1 diabetic participants on percent of calories from fat and number of daily vegetable servings . For type 2 diabetic participants , sex , disease-specific quality of life , percent calories from fat , and number of daily vegetables servings differed across stages . Those in action stages were more likely to be female and have a better quality of life and healthier eating habits .  Type 2 diabetic insulin-requiring participants in action stages were more likely to be married . Social support was highest for those in the contemplation stage and lowest for those in the action stage . Type 2 diabetic participants on pills in the action stages were older , had a lower BMI , ate more fruit , were nonsmokers , recently attended diabetes education , had a better quality of life and social support , and had less stress . One anomalous finding for type 2 diabetic participants was that precontemplators scored similarly to those in action stages . CONCLUSIONS These data vali date the Transtheoretical Model , where those in the action stages displayed healthier eating . They also indicate that demographic and psychosocial factors may mediate readiness to change diet . Precontemplators were a heterogeneous group and may need individually tailored interventions OBJECTIVE To assess whether knowledge or psychosocial and glycemic benefits of a diabetes education program are enhanced by a support group for older patients . DESIGN A partially r and omized controlled trial involving two groups of patients : Group A , subjects who received an education program followed by 18 months of support group sessions ; Group B , only the diabetes education program . A third convenience sample , Group C , received neither intervention . Groups A and B were assessed before and immediately after the education program , and all groups were assessed 2 years after the education program . SETTING Diabetes clinic at a Veterans Affairs Medical Center . PATIENTS All subjects were male ( mean age = 68 + /- 1.3 years , range = 57 - 82 years ; duration of diabetes = 10 + /- 2 years , range 3 - 16 ) . Sample sizes were 11 in Group A , 13 in Group B , and 8 in Group C. INTERVENTION The education program consisted of six weekly sessions covering aspects of diabetes self-care . The support group consisted of 18 monthly sessions for continuing education , discussion , and structured social activities . OUTCOME MEASURES Diabetes knowledge , psychosocial factors ( self-care-related quality of life , stress , family involvement in care , and social involvement ) , depression , and glycemic control . RESULTS Group A scored better ( at least P less than 0.05 ) on knowledge , quality of life , and depression than the other groups . Groups A and B showed less stress , greater family involvement , better glycemic control , but less involvement in social activities than Group C. CONCLUSION Diabetes education programs can have long term benefits on knowledge , psychosocial functioning , and glycemic control for older diabetic patients . The addition of support groups enhances diabetes knowledge and psychosocial functioning BACKGROUND Ongoing self-management improves outcomes for those with Type 2 diabetes ( T2D ) ; however , there are many barriers to patients receiving assistance in this from the healthcare system and peers . Findings from our pilot study showed that a virtual diabetes community on the Internet with real-time interaction among peers with T2D- and with healthcare professionals-is feasible and has the potential to influence clinical and psychosocial outcomes . OBJECTIVE The purpose of this article is to present the protocol for the Diabetes Learning in Virtual Environments ( LIVE ) trial . PROTOCOL Diabetes LIVE is a two-group , r and omized controlled trial to compare effects of a virtual environment and traditional Web site on diet and physical activity . Our secondary aims will determine the effects on metabolic outcomes ; effects of level of engagement and social network formation in LIVE on behavioral outcomes ; potential mediating effects of changes in self-efficacy ; and diabetes knowledge , diabetes-related distress , and social support on behavior change and metabolic outcomes . We will enroll 300 subjects at two sites ( Duke University/Raleigh-Durham , NC and New York University/New York , NY ) who have T2D and do not have serious complications or comorbidities . Those r and omly assigned to the intervention group have access to the LIVE site where they can find information , synchronous classes with diabetes educators , and peer support to enhance self-management . Those in the control group have access to the same informational and educational content in a traditional asynchronous Web format . Measures of self-management , clinical outcomes , and psychosocial outcomes are assessed at baseline and 3 , 6 , 12 , and 18 months . DISCUSSION Should LIVE prove effective in improved self-management of diabetes , similar interventions could be applied to other prevalent chronic diseases . Innovative programs such as LIVE have potential for improving healthcare access in an easily disseminated alternative model of care that potentially improves the reach of self-management training and support Purpose : Test a practice -based intervention to foster involvement of a relative or friend for the reduction of cardiovascular risk in patients with type 2 diabetes . Methods : We enrolled in a r and omized controlled trial 199 patients and 108 support persons ( SPs ) from 18 practice s within a practice -based research network . All patient participants had type 2 diabetes with suboptimal blood pressure control and were prepared to design ate a SP . A subset of the patients also had dyslipidemia . All study visits were conducted at the practice sites where staff took st and ardized blood pressure measurements and collected blood sample s. All patients completed one education session and received newsletters aim ed at improving key health behaviors . Intervention group patients included their chosen SP in the education session and the SPs received newsletters . Results : After 9 to 12 months , the intervention had no significant effect on systolic blood pressure , HbA1C , health-related quality of life , patient satisfaction , medication adherence , or perceived health competence . Power was insufficient to detect an effect on low-density lipoprotein cholesterol . Baseline cardiovascular risk values were not very high , with mean systolic blood pressure at 140 mm Hg ; mean HbA1C at 7.6 % ; and mean low-density lipoprotein at 137 mg/dL. Patient health care satisfaction was high . Conclusion : This practice -based intervention to foster social support for chronic care management among diabetics had no significant impact on the targeted outcomes OBJECTIVE Examine influences of diabetes-specific social support ( D-SS ) and depressive symptoms on glycemic control over time , among adults r and omized to a diabetes self-management education and support ( DSME/S ) intervention or usual care .  METHODS Data were from 108 African-American and Latino participants in a 6-month intervention trial . Multivariable linear regression models assessed associations between baseline D-SS from family and friends and depressive symptoms with changes in HbA1c . We then examined whether baseline D-SS or depression moderated intervention-associated effects on HbA1c . RESULTS Higher baseline D-SS was associated with larger improvements in HbA1c ( adjusted ΔHbA1c -0.39 % for each + 1-point D-SS , p=0.02 ) , independent of intervention-associated HbA1c decreases . Baseline depressive symptoms had no significant association with subsequent HbA1c change . Neither D-SS nor depression moderated intervention-associated effects on HbA1c . CONCLUSIONS AND PRACTICE IMPLICATION S Diabetes self-management education and support programs have potential to improve glycemic control for participants starting with varying levels of social support and depressive symptoms . Participants starting with more support for diabetes management from family and friends improved HbA1c significantly more over 6 months than those with less support , independent of additional significant DSME/S intervention-associated HbA1c improvements . Social support from family and friends may improve glycemic control in ways additive to OBJECTIVE To explore quantitatively the extent to which social support , social norms  and  barriers  are associated with self-efficacy and self-care adherence in Hispanic patients with diabetes and the extent to which these differ for men and women . METHODS Baseline survey data were collected from 248 low-SES , Hispanic men and women who were participants in a r and omized controlled trial of a culturally targeted intervention for diabetes management .  Student 's t , Pearson correlations and multiple regression were used to analyze the data . RESULTS Compared to men , women were less likely to receive support , faced more barriers , reported less self-efficacy and had lower levels of self-care adherence . Perceived support was consistently correlated with better self-efficacy in women but not men , even though men reported higher levels of support . CONCLUSION The lack of adequate support seems to be a fundamental barrier for Hispanic women with diabetes . PRACTICE IMPLICATION S Health care providers should be sensitive to sociocultural influences in Hispanic groups that may facilitate men 's self-care adherence , but could potentially hamper women 's efforts . Interventions design ed for Hispanics should augment women 's support needs and address culture and social factors that may differentially impact the ability of men and women to manage their diabetes Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal . More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of re sources needed for long-term condition self-management to be effective . Aim To determine how the social networks of people with long-term conditions ( diabetes and heart disease ) are associated with health-related outcomes and changes in outcomes over time . Methods Patients with chronic heart disease ( CHD ) or diabetes ( n = 300 ) r and omly selected from the disease registers of 19 GP practice s in the North West of Engl and . Data on personal social networks collected using a postal question naire , alongside face-to-face interviewing . Follow-up at 12 months via postal question naire using a self-report grid for network members identified at baseline . Analysis Multiple regression analysis of relationships between health status , self-management and health-economics outcomes , and characteristics of patients ' social networks . Results Findings indicated that : ( 1 ) social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being ; ( 2 ) support work undertaken by personal networks exp and s in accordance with health needs helping people to cope with their condition ; ( 3 ) network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs . Health service costs were significantly ( p<0.01 ) reduced for patients receiving greater levels of illness work through their networks . Conclusions Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon . This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community groups and re sources for producing a more desirable and cost-effective way of supporting long term illness management Background Culturally appropriate interventions are needed to assist Latinas in making multiple healthful lifestyle changes . Purpose The purpose of this study was to test a cultural adaptation of a successful multiple health behavior change program , ¡ Viva Bien ! Methods R and om assignment of 280 Latinas with type 2 diabetes to usual care only or to usual care + ¡ Viva Bien !  , which included group meetings for building skills to promote the Mediterranean diet , physical activity , stress management , supportive re sources , and smoking cessation . Results ¡ Viva Bien ! participants compared to usual care significantly improved psychosocial and behavioral outcomes ( fat intake , stress management practice , physical activity , and social – environmental support ) at 6 months , and some improvements were maintained at 12 months . Biological improvements included hemoglobin A1c and heart disease risk factors . Conclusions The ¡ Viva Bien ! multiple lifestyle behavior program was effective in improving psychosocial , behavioral , and biological/ quality of life outcomes related to heart health for Latinas with type 2 diabetes ( Clinical Trials.gov no : NCT00233259 )
CONCLUSIONS Despite a compelling theoretical base , research ers have only minimally studied the value of interventions targeting patients ' social networks on diabetes care .
OBJECTIVES In the care of patients with type 2 diabetes , self-management is emphasised and studied while theory and observations suggest that patients also benefit from social support .
We sought to assess the effect of social network interventions on social support , glycaemic control and quality of life in patients with type 2 diabetes .