Work

The Role of Diabetes Distress and Self-Efficacy as Mediators of Barriers to Diabetes Self-Management in Young Adults With Type 1 Diabetes: A Cross-Sectional Study

Year: 2025

Type: article

Abstract: OBJECTIVE: This study examined how structural and contextual barriers, including social needs and gender, influence diabetes self-management (DSM) through psychosocial pathways, particularly diabetes distress (DD) and self-efficacy (SE). Although these barriers are well documented, their interactions with psychosocial factors remain underexplored. RESEARCH DESIGN AND METHODS: = 198). Using hierarchical regression, we assessed factors influencing DSM. Structural predictors included unmet social needs and limited insulin access; contextual predictors included gender and ethnicity. Hypothesized mediators were the scores on the Diabetes Distress Scale, the Diabetes Empowerment Scale, and the Audit of Diabetes Dependent Quality of Life. After identifying significant predictors and potential mediators through hierarchical multivariate regression analysis, separate path models were tested for each hypothesized mediator. RESULTS: Unmet social needs, as well as female and nonconforming genders, were found likely to increase DSM challenges. All selected predictors became nonsignificant when accounting for all psychosocial variables. DD mediated all tested relationships, and SE partially mediated the relationship between unmet social needs and DSM. CONCLUSION: The proposed model suggests the need for targeted interventions addressing psychosocial pathways, particularly DD and SE, to mitigate the downstream effects of structural barriers to DSM. Inclusive gender-specific care models and systemic reforms to reduce social inequities are crucial for improving DSM outcomes and overall well-being.

Source: Diabetes Spectrum

DOI: 10.2337/ds24-0087

Authors: Ngozi D. Nnoli, John Sideris, Pey-Jiuan Lee, Steven Fox, Jennifer K. Raymond, Elizabeth A. Pyatak

Institutions: University of Southern California, Children's Hospital of Los Angeles

Language: English

Topic: Diabetes Management and Education

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: green

Funder: National Institute of Diabetes and Digestive and Kidney Diseases