Psychosocial Factors Associated with Diabetes Distress Among Adults with Type 2 Diabetes Mellitus: The Roles of Perceived Social Support and Diabetes Management Self-Efficacy in an Indonesian Outpatient Sample.

Abstract

Purpose: Diabetes distress represents a diabetes-specific emotional burden associated with the challenges of long-term diabetes management. Psychosocial factors, including perceived social support and diabetes management self-efficacy, may influence how individuals experience and adapt to type 2 diabetes mellitus (T2DM). However, the relationships among these factors remain insufficiently characterized when diabetes distress is considered the primary outcome. This study aimed to examine the associations among perceived social support, diabetes management self-efficacy, and diabetes distress among adults with T2DM receiving outpatient care in Indonesia.

Patients and methods: An analytical observational study with a cross-sectional design was conducted among 107 adults with physician-confirmed T2DM attending an internal medicine outpatient clinic in South Sumatra, Indonesia. Participants were recruited using consecutive sampling. Perceived social support, diabetes management self-efficacy, and diabetes distress were assessed using the Indonesian versions of the Multidimensional Scale of Perceived Social Support, Diabetes Mellitus Self-Efficacy Scale, and Diabetes Distress Scale. Associations among variables were examined using correlation analysis and regression-based path analysis with bootstrap estimation.

Results: Participants had a mean age of 54.14 ± 10.82 years, and 76.6% were women. Overall, 26.2% of participants experienced moderate-to-high diabetes distress. Perceived social support was not significantly associated with diabetes management self-efficacy or diabetes distress. In contrast, diabetes management self-efficacy was negatively associated with diabetes distress and remained significant after adjustment for perceived social support and age. The indirect association between perceived social support and diabetes distress through diabetes management self-efficacy was not statistically significant.

Conclusion: Among adults with T2DM receiving outpatient care, diabetes management self-efficacy was associated with lower diabetes distress, whereas generalized perceived social support was not significantly associated with diabetes distress or diabetes management self-efficacy. These findings highlight the importance of considering diabetes management self-efficacy as a psychosocial component of patient-centered diabetes care. Future studies should examine whether diabetes-specific support interventions may provide greater benefit than generalized social support for improving psychosocial outcomes among individuals with T2DM.