Social support and diabetes self-care among African American adults with type 2 diabetes: A systematic review

Type 2 diabetes (T2D) disproportionately affects African American adults in the United States, who experience higher complication rates and poorer outcomes. Social support is a key determinant of diabetes self-care, yet evidence in this population remains fragmented. This review aimed to synthesize evidence on the types, soucres and impact of social support on diabetes self-care behaviours among African American adults with T2D.

A systematic review was conducted following PRISMA guidelines and registered with PROSPERO (CRD420261284391). Four databases (PubMed, CINAHL, APA PsycINFO and Web of Science) were searched for studies published between January 2015 and December 2025. Eligible studies included African American adults (≥18 years) with T2D and examined at least one component of social support. Data extraction and quality appraisal using the Mixed Methods Appraisal Tool were performed by multiple reviewers. A convergent narrative synthesis approach was used to integrate qualitative, quantitative and mixed-methods findings due to substantial methodological heterogeneity.

Eleven studies (four quantitative, six qualitative and one mixed methods) were included. Social support types included emotional, informational, instrumental, appraisal, spiritual and companionship support, delivered through family, peers, healthcare providers, community health workers and faith-based organizations. Overall, social support was associated with improved adherence to diet, physical activity, medication use and glucose monitoring. Peer-led and culturally tailored interventions were associated with enhanced engagement through shared identity, trust and accountability. Conversely, negative or controlling support was associated with poorer adherence and greater diabetes-related distress.

Social support is a multifaceted and culturally embedded determinant of diabetes self-care among African American adults with T2D. Findings suggest that culturally relevant, autonomy-supportive and community-based interventions may strengthen self-management behaviours and help address persistent diabetes disparities.