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Lower socioeconomic (SE) groups are not only disproportionately
affected by type 2 diabetes, they also have
more diabetes-related complications and higher diabetes-
related mortality compared to diabetic patients in
higher SE groups [1-3]. A possible explanation for this
could be poorer glycaemic control. Achieving optimal
glycaemic control requires the diabetic patient to take
part in a complex set of tasks: adhere to dietary advice
and medications, engage in regular physical activity, quit
smoking, and monitor blood glucose levels, known as
diabetes self-management (DSM) [4]. These tasks seem
to be more challenging for diabetic patients in lower SE
groups [5-7].
Interventions aimed at improving DSM can contribute
to better glycaemic control and the prevention of diabetes-
related complications [8,9]. However, there are
indications that interventions for the general diabetic
population are less suitable for lower SE groups and
need to be adapted to the specific barriers they face
[10,11]. Barriers to DSM among lower SE groups
include a lack of knowledge of diabetes, low self-efficacy,
low perceived control, and low health literacy [5,7,12].
Another mentioned barrier to DSM among lower SE
groups is a lack of diabetes-related social support
[13-15]. To maintain lifestyle changes, long-term social
support in particular seems beneficial [13,16]. From
other fields such as sociology we know that social support
is not the only psychosocial mechanism through
which the immediate social environment influences
health [17-19]. Other psychosocial mechanisms are

http://www.biomedcentral.com/content/pdf/1471-2458-12-199.pdf

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