Living with diabetes: The value of everyday communication

The unrelenting demands of diabetes self-care, fluctuating glucose levels and critical glucose events make diabetes salient in the social life of individuals living with diabetes. Thus, everyday talk about diabetes is implicated as a critical site for investigation. This study employed an interpretive communication framework with four components: reasoning about the diabetes future (analyzed through the lens of Problematic Integration), willingness to talk about diabetes or fear of disclosure, diabetes-related, emotional social support, and perceived alignment on conversations about diabetes. Outcomes examined were diabetes distress, diabetes empowerment and life satisfaction. Participants included 175 individuals with type 1 and type 2 diabetes mellitus, located through convenience sampling across physical and virtual communities. The sample was a relatively homogenous group except for age and years with diabetes. Ages ranged from 18 to 73 and years with diabetes ranged from a few months to 68 years. In a triangulated design participants completed open-ended and scaled questions related to a meaningful, recalled conversation with one other person. The analyses controlled for health status and the time elapsed since the conversation. Findings included the conversation topics, which ranged from the everyday self-care regimen to more complex topics of critical diabetes events, complications, psychological burden or relationship issues. Participants displayed four different reasoning types about their diabetes future: complications are possible but risk may be influenced by self-care, complications are inevitable, acceptance of the impossibility of knowing whether complications will arise and a general optimism not oriented to complications as a future. Two forms of reasoning were associated with distress, empowerment and life satisfaction. A hierarchical coding system for perceived alignment was developed; higher alignment was associated with greater empowerment and life satisfaction. Evaluations of the conversation as achieving mutual understanding and being more person-centered were positively associated with empowerment and life satisfaction. Person-centeredness was also negatively associated with distress. Social support predicted greater empowerment and life satisfaction; fear of disclosure predicted greater distress and less empowerment. Overall, findings display the constitutive nature of everyday communication and demonstrate important relationships between communication dimensions and psychosocial diabetes outcomes.