Abstract Body: Introduction: Social support has been positively related to better glycemic control in individuals with type 2 diabetes (T2D), while loneliness and social isolation are independently associated with poor health behaviors. Little is known about how individuals with controlled vs. uncontrolled T2D experience these three distinct constructs.
Hypothesis: We hypothesized that adults in Puerto Rico with controlled T2D have greater social support and lower levels of loneliness and social isolation compared to those without T2D or uncontrolled T2D.
Methods: We analyzed cross-sectional data from 1,517 adults aged 30-75 years participating in the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT). T2D status (based on laboratory, diagnosis, or medication) was categorized as no T2D, uncontrolled T2D (hemoglobin A1c ≥7%), and controlled T2D (hemoglobin A1c <7%). Primary outcomes included loneliness (3-item UCLA Loneliness Scale; range 3-9; higher = greater loneliness), social isolation (combined social network and activity metrics; range 0-29; higher = less isolation), and social support (Interpersonal Support Evaluation List-12 scale including appraisal, belonging, and tangible subscales; range 0-36; higher = greater support). Multivariable linear models estimated associations between T2D status and these scores, adjusting for sociodemographic and behavioral factors, chronic conditions, and depression.
Results: In the sample, 73.4% did not have T2D, and 26.6% had T2D (14.2% controlled; 12.4% uncontrolled). Individuals with controlled T2D reported significantly higher overall social support score than those without T2D (mean difference= 1.53; 95%CI: 0.11, 2.94). Tangible support (i.e., perceived availability of material aid, such as financial assistance, goods, or services) was notably higher among those with controlled T2D vs. without T2D (mean difference= 0.58; 95%CI: 0.03, 1.13). Adjusting for loneliness and social isolation attenuated these associations to the null. No differences were observed in social support between uncontrolled T2D and other groups, nor in loneliness or social isolation across T2D categories.
Conclusions: Adults living in Puerto Rico with controlled T2D perceive greater social support, particularly tangible support. Relationships between social support, loneliness, and social isolation are complex and should be further explored in the context of T2D control.