Research has shown that families play a key role in how well people with diabetes adjust to the disease, integrate it into their lives, and manage it well. This suggests that good diabetes control depends on a healthy psychological environment. Rosemary Flynn advises on how to achieve this.  

You have diabetes, but in a way your family has diabetes too because you are one part of a whole family, whatever the family looks like: a partnership, married parents with children, grandparents or extended family. Each member of the family has an influence on all the others. On the one hand, how you deal with your diabetes will have an impact on your partner and family, and on the other hand how your partner and family supports you will impact you and how you handle your diabetes.

Creating a healthy psychological environment

If you manage your diabetes well and show that you can cope with the daily demands of diabetes, and get it right, your partner will relax and leave you to it and only be involved when you need it.

If you don’t take responsibility for your diabetes and either ignore it or defy it, your partner will become very anxious and will possibly try to persuade you to do the ‘right thing’ whether it is to do with what you eat or how you exercise or taking medications. They may do it in an annoying way and perhaps will need to learn how to do it more gently, but when you think about it, they have to deal with the stresses that diabetes brings too, particularly if you have Type 1 diabetes.

When your partner has these worries, he or she is not paranoid or unreasonable; they are natural responses because they love you. You may want to be totally independent and cope with your diabetes on your own, but if you are not being responsible about managing your diabetes, your partner will want to help. The more responsible you are, the less they will feel they need to nag you. Some of your partner’s worries would be the following:

• Partners worry a lot about your lows when you have Type 1 diabetes. They’re afraid that you’ll have a low in the night and not wake up, or you’ll become unconscious, or have a seizure, and that they will not wake up to help you. So they often have disturbed nights, because they want to check on you at some time during the night.
• They worry that you’ll ignore the symptoms of a low or not have the glucose you need to address the symptoms.
• Since diabetes is not curable, they fear for your future. They really worry about complications developing, especially when your control is poor.
• They often feel very sad that you have diabetes. They feel it as a loss as much as you do. They may fear that you will die and they will lose you. They also need to be reassured that you can overcome your diabetes.
• When they’re being bossy, it may be because they’re afraid that you’ll get it wrong and they’ll lose you.
• They may feel that the good relationship you had before the diabetes has been lost, and they miss what you had before.

Striking a balance is not easy. How much does your partner play a part, and how much do they leave you to get on with it? This needs to be negotiated between the two of you, until you find a way to work together without conflict. And then there are life stressors that complicate your relationship. Things like:

• family arguments.
• the loss of a loved member of the family or a friend.
• the loss of a job.
• financial strain.
• a traumatic incident such as a car accident.
• a violent crime that touches you.
• excess alcohol consumption.

All of these stressors will have an impact on your relationship while you’re dealing with the difficult circumstances. Both of you will be more anxious and your responses to the anxiety can create uneasiness in the relationship. Add to that, the fact that the stress is pushing your blood glucose levels up and the situation can become quite volatile.

If the difficulty in your relationship with your partner is not resolved in a satisfactory way, conflict and reactions to the dispute can become ongoing. It is so important for you to find a way to normalise your relationship. This is vitally important to your family and to your diabetes! If you need outside help and support to do this, find the help you need.

What can families do to cope with these feelings?

• Talk to each other about diabetes and things that have happened. Talking can help to strengthen the family bond. The idea is to communicate about the issues that are of concern to each other and the way everyone feels about it. Everyone should have a turn to speak, and each person should feel understood and supported so that the issue can be addressed constructively. Respecting each person’s individuality and situation helps to create an atmosphere of acceptance and allows for creative solutions to problems. Any diabetes information or issues can be discussed in this way.
• Talk to other families who also have a member with diabetes. Attend family events organised by diabetes organisations or interested parties. This offers you support and helps you feel less isolated as you deal with the day-to-day care of diabetes. Sometimes other families, especially those who have many years of experience, can share good ideas on how to deal with family issues that arise because of diabetes.
• Be committed to the decisions that are made in the family, but carry these out in a flexible way.
• Be respectful and kind to each other.
• Solve problems together.

This way, feelings are valued and the connection between partners and between all family members is restored and maintained.