A diagnosis of diabetes changes life for the diabetic as well as for a non-diabetic spouse or partner. Diabetes, which is characterised by elevated glucose levels due to the body’s inability to produce sufficient insulin or use it effectively, can have serious health consequences like heart attack, stroke, kidney failure, vision loss, and nerve damage that can lead to numbness in the foot and possibly amputation if unnoticed wounds on the foot do not heal. A person diagnosed with diabetes quickly learns that regulating his or her glucose on a daily basis is critical. Most often, this is done by changing diets and exercise habits.
Diabetes also comes with an increased risk for other physical problems such as erectile dysfunction for men and hypertension and weight gain due to insulin therapy for both men and women. All this can interfere with sexual intimacy. Navigating these changes in the marriage is just as important as managing the dietary and exercise requirements.
All of this can, understandably, be overwhelming for a newly-diagnosed diabetic. But, what diabetes patients and their doctors often overlook is that spouses can help.
Research shows that for diabetes, as for other chronic illnesses, a partner’s support makes a big difference to the patient’s management of the disease. A partner’s support and coping as a team, gives the diabetic more confidence in his or her ability to stick to diets and to exercise and to gain better overall health. The quality of the marriage too benefits from this type of joint coping.
Finding a sweet spot
So, here are six ways to tackle diabetes as a team.
First, talk about the elephant in the room. Research shows that tip-toeing around diabetes and the maelstrom of emotions it brings does not do the diabetic partner or the relationship any good. It is important to name the condition and talk about all it implies. It is also important for partners to not protect each other from their concerns but share their worries openly. For instance, if spouses worry about the negative impact of diabetes and its related dietary restrictions on their social life or their ability to cope with the recommended diabetic care, they should talk about it, without letting guilt stand in the way. Similarly, it is a good idea to explain clearly, to any children in the family, why one parent is suddenly eating differently, using injections or taking medication.
Second, both partners must learn about diabetes management. Reading about diabetes together can help prepare spouses for what is ahead, express solidarity for the diabetic partner and establish that they are a team.
Third, partners must set goals and solve problems together. In all likelihood, reading about diabetes and interacting with doctors will bury the couple under a mountain of information and advice. The challenge is to distil all that advice into something actionable. Research shows that if couples set small goals, identify barriers and solve problems as they emerge, together, the diabetic partner is likely to be healthier and happier.
Fourth, the non-diabetic partner must support and encourage – without nagging – new diet and exercise habits. Spouses, in an attempt to be helpful, can take on too much control over their diabetic partner’s routine. But studies show that nagging, for instance, by reminding a partner daily to exercise or criticising, for instance by, calling them out in public about their food choice, is counterproductive. It tends to reduce the diabetic partners’ adherence to diet and exercise habits.
People with chronic ill health can also become sensitive to the mildest attempt to control them which is understandable given that they receive unsolicited advice constantly and from all quarters. Spouses should try to express faith in their partner’s ability to manage the condition themselves which is much more effective, according to research, in helping them enact new habits.
Fifth, spouses be patient. Although eating healthy and exercising regularly is indispensable for diabetic people, spouses need to be prepared for the natural and inevitable ups and downs in the diabetic partner’s motivation to practice healthy habits. Beginning and maintaining lifestyle changes is a lot of effort. And chronic ill health is a drain on the very energy and motivation you need to stick with lifestyle changes. So, in addition to supporting healthy habits, being patient and allowing the diabetic partner to figure out their own priorities and pace of change is important.
Finally, a spouse should get outside support. Care of a diabetic is demanding and trying to manage it all alone can lead to burnout. Communicating with other family members about the diagnosis and specifying how they can support its management is one way to lessen the load. Similarly, confiding in friends about how diabetes is impacting the couple’s life and marriage on a day-to-day basis can be helpful. Talking to other couples where one partner has diabetes can also lessen the caregiver’s feelings of loneliness and provide ideas for practical coping strategies. And one can always seek professional help from medical specialists, dieticians and counselors.
Receiving a diagnosis of diabetes does not have to derail one’s life and marriage. Communicating regularly about diabetic care, expressing support and affection, solving problems together and seeking external support can increase the odds of successfully managing diabetes and protecting one’s marriage, lifelong.
The writer has a PhD in Couples and Family Therapy and practices as a couples therapist in Mumbai.