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    Living With Type 2 Diabetes Is Family Affair

    Family involvement is crucial to diabetes control.

    We Are Family

    Families mean different things to different people at different times of their lives, says Alan M. Jacobson, MD, head of behavioral and mental health research at Harvard University's Joslin Diabetes Center in Boston.

    "Every family situation is different," Jacobson tells WebMD. "Not every family is two 55-year-olds with 22-year-old kids living down the block. Where there is a support system that is meaningful -- probably a spouse and adult children who may or may not be in the same community -- it pays to try to draw them in. When patients go to their diabetes educators, it helps for family members to sit down with the nurse or dietician to plan out what they are going to do here."

    Americans' average age at the time of diabetes diagnosis is 46 years. Older people with diabetes may need to rely more on their spouses, especially if their children, parents, and siblings no longer live in the same household -- or even the same city. Younger people with diabetes face the uphill struggle of getting everyone in the household to pull together as a team.

    And Americans are a people of many different cultures, notes Lawrence Fisher, PhD. Fisher is professor of family and community medicine and director of behavioral diabetes research at the University of California, San Francisco, School of Medicine.

    "The broader culture is transmitted and changed by the family culture," Fisher tells WebMD. "'The beliefs that go back many generations help define what care is, what disease is, and what you can do about it. Experience plays a role, too. There are attitudes like, 'My aunt had diabetes, and even with modern technology, she had three amputations and died. So what can I do?' A lot of that is reinforced by family beliefs. These beliefs have a huge effect on disease management."

    Family beliefs thus spring both from a family's culture and from a family's experience. This doesn't mean that everybody in the family is going to feel the same way, and agree on the same course of action. Far from it: Differences arise in every family faced with a health crisis. Resolving these differences means recognizing and giving voice to these differences.

    Sometimes it also means struggling to change our cultural attitudes, Jacobson says.

    "We live in a society where we now have way more food our bodies were designed to need," he says. "We expect more and more because the culture tells us to want more and more. We attempt to rebel -- through exercise and fitness -- but that means fighting against our culture."

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