Mapping the Social Context of Type 2 Diabetes Management: A Network Analysis of Disease-Related Complications Among Black/African American Men

Social networks play a crucial role in type 2 diabetes (T2D) management, yet limited research examines these dynamics among Black/African American men who face disproportionate T2D burden. This study investigated associations between social network characteristics and negative T2D outcomes among 1,225 Black/African American men with T2D. Participants completed an online survey assessing their social networks and T2D outcomes including low blood sugar reactions, high blood sugar symptoms, and ketone presence. Multiple linear regression analyses revealed that while frequent diabetes-specific discussions were associated with more negative outcomes (β = .329, p < .001), general communication frequency (β = -.221, p < .001) and having very supportive network members (β = -.209, p < .001) demonstrated negative associations. Higher proportions of family members, including siblings (β = .089, p = .034), extended family (β = .105, p = .012), and children (β = .087, p = .015), in networks were associated with increased negative outcomes. Physical activity levels within networks showed significant negative association (β = -.093, p = .008), while perceived healthy eating behaviors showed no significant associations. These findings suggest the complex nature of social support in T2D management, where the quality of support may be more influential than quantity, and where family relationships may introduce competing demands that complicate disease management. Results emphasize the importance of considering both communication patterns and relationship dynamics in developing culturally tailored interventions for Black/African American men with T2D. Future research should examine how these social network characteristics evolve over time and influence long-term T2D outcomes.