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Participants starting with more support for diabetes management from family and friends improved Hb A1c significantly more over 6 months than those with less support, independent of additional significant DSME/S intervention-associated Hb A1c improvements.

Social support from family and friends may improve glycemic control in ways additive to DSME/S.

Diabetes-specific social support (D-SS) refers to social support for diabetes care tasks, and is frequently studied in the context of laypeople such as family members, friends, or peers with diabetes.

In observational studies, higher levels of social support are associated with better diabetes self-management, including better medication adherence, consistent blood glucose monitoring, healthier eating, and more physical activity.

a comprehensive diabetes management intervention with low social support have more improvement in their glycemic control from the intervention.

Higher levels of depressive symptoms have been more conclusively linked with worse glycemic control among people with diabetes, particularly through worse self-management behaviors.

Neither increasing diabetes social support from family and friends, nor reducing depressive symptoms were goals of the intervention.

Neither D-SS nor depression moderated intervention-associated effects on Hb A1c.

Diabetes self-management education and support programs have potential to improve glycemic control for participants starting with varying levels of social support and depressive symptoms.

We sought to address these gaps in knowledge by examining the influences of baseline D-SS and depressive symptoms, separately and together, on changes in glycemic control over a six month period among adults who were randomized to receive either a comprehensive DSME/S intervention or usual care over that time period.

We hypothesized that higher baseline levels of D-SS and lower baseline levels of depressive symptoms would be associated with larger subsequent improvements in Hb A1c among participants in both groups.

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