Diabetes Self-Management Articles

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Diabetes and Your Marriage
Making Things Work

by Paula M. Trief, PhD

It’s hard to have a chronic illness like diabetes. You have to watch your weight, make healthy food choices, exercise, take insulin or oral medicines in many cases, and see several health-care providers on a regular basis. But there’s more to it than that: You must carry out these tasks while also being worried that you may develop complications such as eye or kidney problems or while feeling depressed or overwhelmed.

Having the support of others can help ease the feelings of fear or frustration that often go along with having diabetes. Research has clearly shown that people who have social support tend to do better managing their diabetes. Social support can mean different things to different people. You may feel supported when a family member offers to take you to a doctor visit. You may feel supported when a friend listens and lets you cry about how frustrated you feel. Or you may feel supported when your sister walks with you each morning so that you can stick with your exercise program.

When people with diabetes feel they have people who care about them, people they can talk to about their deepest feelings, they are more likely to stick to their self-care regimen, to have better blood glucose control, and to feel positive about their ability to cope with diabetes.

When you are married (and 85% of adults are married at some point) or in a committed relationship, the most important source of support is usually your spouse or partner. However, the marital relationship can also be the greatest source of conflict and stress. This article explores how a couple’s relationship may affect diabetes, how diabetes may affect the relationship, and how couples can work together to have both a healthy relationship and good diabetes control.

One affects the other
The quality of your relationship with your intimate partner can affect your general health and your diabetes control. Studies that have looked at the effect of marital stress on health have shown that your immune system, heart, and blood glucose control can all be negatively affected if you have a high degree of conflict and stress in your interactions with your partner. Your partner’s involvement in your daily diabetes care can also make a lot of difference. It can make a positive difference if, for example, your partner prepares nutritious meals, keeps track of your medicines for you, or exercises with you.

As for diabetes affecting the relationship, a partner can experience many of the same negative feelings as the person with diabetes. He may feel scared about what the future holds. Will his partner develop complications? Will she get sicker? Will she continue to be able to do the things they have enjoyed doing together? These are common fears that partners have. A partner may be angry, especially if the diabetes has been linked to being overweight, or depressed about the extra medical bills. While fear and sadness are common feelings, different couples deal with these feelings differently, and how they cope can result in either greater conflict or more closeness.

A tale of two couples
The Smiths and the Joneses illustrate two different models for coping with diabetes as a couple. Both couples have been married for 20 years, both have two teenaged children, in both couples both partners work, and in both couples it is the husband who has had diabetes for 10 years. But their relationships are very different.

Mr. Smith hates the fact that he has diabetes and doesn’t do much to take care of himself. He does inject insulin two times per day the way his doctor instructed him to, but he doesn’t monitor his blood glucose level, he eats whatever he wants, and he regularly skips his medical appointments. He’s had some vision and foot numbness problems. Mrs. Smith is very worried about her husband and frequently reminds him (Mr. Smith would call it “nagging”) to monitor, take his blood pressure medicines, and watch what he eats. Mrs. Smith does the food preparation for the family, and she tries to limit the fat and sugar in their diet, but Mr. Smith gets mad if she says anything about his reaching for a second helping or getting ice cream when they are out. She responds by telling him he should feel grateful that she is trying to help. They fight about his diabetes a lot. With all of the tension, they have both decided that it’s better to avoid the topic of diabetes altogether, so they try not to talk about it.

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