“Are you sure you’re going to have another one of those?”

ACBRD and colleagues in Sydney publish paper on perceptions of social control and social support relating to the self-management of type 2 diabetes

by Dr Adriana Ventura

Family and partners of those with type 2 diabetes (T2D) are often drawn into the self-management process. These close relationships can have both positive and negative impacts on the person’s self-management. Less is known about the influence of the wider social network (e.g. friends, work colleagues). Our aim was to explore the perceived impact of the immediate and wider social network on a person’s self-management of T2D.

A total of 25 adults with T2D were interviewed about the ‘social experience’ of living with T2D.  We used two frameworks for understanding the ways in which a social network can influence coping and behaviours: a) the health-related social control model (i.e. attempts to correct or improve self-management) and b) social support model (i.e. the provision of encouragement and positive feedback). Four main themes were identified, including two themes that were established a priori (i.e. social control and social support), and two themes that emerged from the data (i.e. non-involvement and unintentional undermining).

Perhaps surprisingly, social control wasn’t always perceived negatively, with some people feeling appreciative and accepting of the ‘controlling’ behaviour exerted by those in their social network. Others, however, felt that the controlling behaviour was intrusive and critical. Overall, most participant felt that their social network offered support in the form of practical assistance and/or emotional validation. ‘Non-involvement’ emerged as a new theme, and was the most prevalent overall.  While some preferred that their social network were not involved in their diabetes management, others perceived their diabetes to be unimportant to others and wished for more input. The second and least frequently occurring theme to emerge from the data was ‘unintentional undermining’. This referred to participants’ perceiving thoughtless but insensitive behaviours/remarks from the social network.

Although family members have the most significant influence on T2D management, this study shows that friends and work colleagues also play a role. Therefore, increasing awareness of diabetes self-management is important across all relevant social networks.

Newton-John TRO, Ventura AD, Mosely K, Browne JL, Speight J. ‘Are you sure you’re going to have another one of those?’: A qualitative analysis of the social control and social support models in type 2 diabetes. Journal of Health Psychology. 2017; 22(4), 1819-1829.

Eating behaviours of adolescents with type 1 diabetes. Does gender matter?

Another paper of the Diabetes Miles Youth – Australia study has recently been published.

by Dr Christel Hendrieckx

This paper reports the results of the first Australian study on prevalence of problematic eating behaviours and body dissatisfaction in a national sample of adolescents with type 1 diabetes using diabetes-specific and gender-specific measures. Participants in the Diabetes MILES Youth between the age of 13 and 19 years (N=477) completed the Diabetes Eating Problem Survey -Revised (DEPS-R) and the Body Mass Index Silhouette Matching Test (BMI-SMT).

Females had higher scores on the DEPS-R than males, with scores for females increasing with age. Another difference for gender was that 50% of female and 18% of male adolescents scored above the DEPS-R cut-off. This cut-off has been defined as a greater risk for problematic eating behaviours. Self-reported BMI, HbA1c, insulin omission, and binge eating frequency were associated moderately with DEPS-R for both genders. This is a novel and important finding demonstrating that male adolescents with type 1 diabetes are also impacted by problematic eating behaviours, and adds to the paucity of research into this understudied subgroup.

Only 10% of females and 24% of males were satisfied with their actual body size. For those who were dissatisfied there was a difference in gender. 88% of the females and 43% of the males expressed a desire to be thinner; while 33% of males and 2% of the females desired a larger body size. Body dissatisfaction and DEPS-R were positively associated for both genders. The adolescents were also asked to indicate the size they believed they would be without diabetes. 59% of females and 38% of males believed they would be bigger than their ideal size without diabetes; 25% of females and 39% of males believed they would be at their ideal size if they did not have type 1 diabetes.

Our study provided support for the DEPS-R to be a useful screening tool for identifying problematic eating behaviours as well as potential body image issues, among female adolescents with type 1 diabetes. However, for the majority of male adolescents, specific items within the DEPS-R may require modification or additional items to better capture their desire to be more muscular. Further, we believe that elevated DEPS-R scores provide an indication that the adolescent experiences difficulties in combining management of their diabetes, weight and healthy eating. Consequently, individuals with high DEPS-R scores warrant attention, and may require additional support with their diabetes management and/or are potentially at risk of developing an eating disorder.

Araia E, Hendrieckx C, Skinner T, Pouwer F, Speight J, King RM. Gender differences in disordered eating behaviors and body dissatisfaction among adolescents with type 1 diabetes: Results from Diabetes MILES Youth—Australia. International Journal of Eating Disorders, 2017, DOI: 10.1002/eat.22746