The research, led by Leila Mardanian Dehkordi of the Nursing and Midwifery Care Research Center at Isfahan University of Medical Sciences in Iran, together with Mohammadreza Razeghi, Alireza Razeghi, and Samereh Abdoli of the University of Tennessee, examined the relationship between sense of belonging and diabetes self-management in adults with type 1 diabetes. While social support has been studied extensively in diabetes care, the investigators focused on a related but distinct construct: sense of belonging, defined as the subjective experience of being accepted, valued, and connected to others. It is not simply about how many people are around you, but whether you feel genuinely embraced by them.

To capture that experience, the team recruited 205 adults with type 1 diabetes through multistage cluster sampling from community healthcare centers in Isfahan, Iran. Participants completed two validated instruments: the Sense of Belonging Instrument, known as the SOBI, and the Diabetes Self-Management Questionnaire–Revised, or DSMQ-R. The SOBI distinguishes between two complementary dimensions. The first, SOBI-P, measures the psychological experience of belonging—the felt sense of acceptance and value. The second, SOBI-A, measures what researchers call antecedents of belonging: the concrete circumstances, such as social fit and shared characteristics with others, that make that psychological experience possible in the first place.

The DSMQ-R, meanwhile, breaks diabetes self-management into clinically meaningful domains: glucose management and monitoring, dietary control, physical activity, contact with physicians, and an overall self-management score. By pairing these two instruments, the researchers could ask a precise question: does feeling connected to others track with doing a better job of managing a demanding chronic illness?

The answer, on several fronts, was yes. Participants who reported a greater sense of belonging also reported better overall diabetes self-management. When the researchers unpacked the two dimensions of belonging separately, an interesting pattern emerged. The psychological experience of belonging—SOBI-P—was positively associated with glucose management and monitoring, dietary control, physician contact, and the overall self-management score. In other words, people who felt accepted and valued were more likely to check their sugars, watch their diets, and keep up with their doctors.

The antecedent dimension, SOBI-A, told a complementary story. It was associated with dietary control, physical activity, and overall self-management. This suggests that the concrete social conditions that enable belonging—having people around you with whom you share experiences and feel at ease—may translate into behavioral engagement, particularly in the domains of eating well and staying active. Both dimensions of belonging remained significantly associated with overall diabetes self-management in multiple regression analyses, indicating that the relationship held when accounting for other variables in the model.

Importantly, the researchers are careful about what the study does and does not show. The effect sizes they observed were modest, and because the design was cross-sectional—capturing a single moment in time—it cannot establish whether belonging drives better self-management, whether people who manage their diabetes well come to feel more connected, or whether both are shaped by some third factor such as depression, socioeconomic stability, or general health. Nor did the study find a significant association between either dimension of belonging and self-reported HbA1c, the laboratory measure of average blood sugar over the preceding months. Self-management behaviors and glycemic outcomes are related but not identical, and the path from feeling connected to lower HbA1c is clearly not a straight line.

Still, the theoretical grounding of the study gives the findings plausibility. Sense of belonging is a core element of self-determination theory, one of the most influential frameworks in motivational psychology, which holds that human beings have fundamental needs for autonomy, competence, and relatedness. When the relatedness need is met, people are more internally motivated to pursue goals—including health goals. Living with type 1 diabetes, moreover, is often an isolating experience. Many adults describe hiding their condition, skipping insulin doses in social settings, or feeling misunderstood by friends and family who underestimate the disease’s demands. In that light, a felt sense of belonging could plausibly lower the emotional friction of daily self-care, making it easier to test glucose in public, ask for accommodations, or admit to a doctor that a regimen is slipping.

The clinical implications, though preliminary, are tangible. The authors suggest that strategies fostering belonging and meaningful social connections may complement existing diabetes self-management education and support programs. That could mean structured peer support groups, community-based programs for people with type 1 diabetes, or clinical workflows that screen for social isolation alongside HbA1c. It also resonates with a broader shift in chronic disease care toward recognizing psychosocial factors—loneliness, belonging, social integration—as legitimate targets of intervention rather than soft background variables. If the experience of being accepted and valued measurably tracks with the grit of daily diabetes work, then belonging is not a luxury; it is part of the treatment environment.

The study also carries a caution for how the field interprets such findings. Modest correlations in a single community sample of 205 adults in one Iranian city do not settle the question of causation, and self-reported self-management is an imperfect window into actual behavior. Future longitudinal and intervention studies will be needed to test whether deliberately cultivating belonging—through peer mentoring, group clinics, or community engagement—produces durable improvements in self-management and, ultimately, in glycemic control. Yet even with those caveats, the message is compelling in its simplicity: the drive to belong, so often treated as separate from medicine, may be quietly woven into the hardest work patients do every day. For adults carrying the constant cognitive load of type 1 diabetes, feeling seen and valued by others may be one of the quiet resources that keeps the counting, the injecting, and the monitoring going. Science is only beginning to measure how much that invisible connection matters—and this study suggests it matters more than we might think.

Subject of Research: The correlation between sense of belonging and diabetes self-management in adults with type 1 diabetes

Article Title: Correlation between sense of belonging and diabetes self-management among adults with type 1 diabetes

Article References: Mardanian Dehkordi, L., Razeghi, M., Razeghi, A., & Abdoli, S. (2026). Correlation between sense of belonging and diabetes self-management among adults with type 1 diabetes. BMC Endocrine Disorders. https://doi.org/10.1186/s12902-026-02581-8

Image Credits: AI Generated

DOI: 10.1186/s12902-026-02581-8

Keywords: type 1 diabetes, diabetes self-management, sense of belonging, social connectedness, psychosocial factors, BMC Endocrine Disorders, glucose monitoring, self-determination theory, HbA1c, peer support, chronic disease care, Iran