In adult diabetes patients with cognitive impairment, higher levels of social support for diabetes care may ameliorate the poor glycemic control often seen in these patients.
Dr. Toru Okura, of the University of Michigan, Ann Arbor, and colleagues write in the October issue of the Journal of the American Geriatrics Society that, “Several studies have examined the association between cognitive function and management of diabetes mellitus,” but none has assessed the value of social support in impaired diabetics.
Using data from the 2003 Health and Retirement Study (HRS) Mail Survey on Diabetes and the 2004 wave of the HRS, the researchers first examined whether cognitive impairment in adult diabetics was associated with worse glycemic control.
They further sought to determine whether the level of social support for diabetes care modifies the relationship. Included in the study were 1,097 adults at least 50 years of age (mean 69.2 years) with diabetes mellitus. The 35-point HRS cognitive scale (HRS-cog) was used to measure cognitive function.
The results showed that HbA1c levels were significantly higher in subjects with the HRS-cog scores in the lowest quartile compared to those with scores in the highest quartile. This association was modified by a high level of social support for diabetes care. Among subjects in the lowest cognitive quartile, those with high levels of support had significantly lower odds of having higher HbA1c than those with low levels of support (1.11 versus 2.87, respectively; p = 0.02).
“A comprehensive geriatric assessment aimed at identifying the presence of cognitive impairment, depressed mood, and level of social support may be important in identifying older adults with diabetes who are at risk for poor glycemic control and need additional support for the care of their diabetes,” the researchers explain.
They add that the growing number of older diabetic patients “makes targeting interventions to improve glycemic control an especially important public health goal.”
J Am Geriatr Soc 2009;57:1816-1824