TY - JOUR
T1 - Spousal Influence on Diabetes Self-care
T2 - Moderating Effects of Distress and Relationship Quality on Glycemic Control
AU - Soriano, Emily C.
AU - Lenhard, James M.
AU - Gonzalez, Jeffrey S.
AU - Tennen, Howard
AU - Chow, Sy Miin
AU - Otto, Amy K.
AU - Perndorfer, Christine
AU - Shen, Biing Jiun
AU - Siegel, Scott D.
AU - Laurenceau, Jean Philippe
N1 - Publisher Copyright:
© 2020 Society of Behavioral Medicine 2020. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2021/2
Y1 - 2021/2
N2 - Background: Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. Purpose: We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. Methods: Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. Results: The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. Conclusions: This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.
AB - Background: Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. Purpose: We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. Methods: Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. Results: The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. Conclusions: This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.
KW - Continuous glucose monitoring
KW - Diabetes distress
KW - Relationship quality
KW - Social control
KW - Type 2 diabetes
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U2 - 10.1093/abm/kaaa038
DO - 10.1093/abm/kaaa038
M3 - Article
C2 - 32491154
AN - SCOPUS:85102965312
SN - 0883-6612
VL - 55
SP - 123
EP - 132
JO - Annals of Behavioral Medicine
JF - Annals of Behavioral Medicine
IS - 2
ER -