The Mediating Role of Perceived Social Support in the Association Between Perceived Stress and Self-Management Behaviors Among Patients with Type 2 Diabetes Mellitus and Metabolic Dysfunction-Associated Steatotic Liver Disease

Ling Ma, Yaling Song, Wei Long, Aiqun LiEndocrinology Department, Hunan Provincial People’s Hospital (The First Hospital Affiliated to Hunan Normal University), Changsha City, Hunan Province, People’s Republic of ChinaCorrespondence: Aiqun Li, Endocrinology Department, Hunan Provincial People’s Hospital (The First Hospital Affiliated to Hunan Normal University), No. 61, Jiefang West Road, Changsha City, Hunan Province, 410005, People’s Republic of China, Tel +86 07312278120, Email liaiqunhnmm@163.comObjective: To examine whether perceived social support mediates the relationship between perceived stress and self-management behaviors in patients with type 2 diabetes mellitus (T2DM) complicated by metabolic dysfunction-associated steatotic liver disease (MASLD), and to provide a theoretical basis for targeted psychosocial interventions in clinical practice.Methods: By convenience sampling, patients with T2DM and MASLD were recruited from a tertiary hospital in Changsha between April 2024 and September 2025. Data were collected using a general information questionnaire, the Chinese Perceived Stress Scale, the Perceived Social Support Scale, and the Chronic Disease Self-Management Behavior Measurement Scale.Results: The mean scores for perceived stress, perceived social support, and self-management behaviors were 25.66 ± 8.02, 56.05 ± 10.28, and 27.63 ± 8.62, respectively. Pearson correlation analysis indicated that dimensions such as loss of control and tension were significantly associated with both social support and self-management behaviors (all P