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    Living With Type 2 Diabetes Is Family Affair

    Family involvement is crucial to diabetes control.

    Resolving Family Roles continued...

    Unless the illness is overlaid on intense, unresolved conflicts, this doesn't mean weeks or months of family therapy.

    "Sometimes just normalizing the emotional response to illness and giving people a space to talk with each other channels things in a constructive direction, rather than all that anxiety getting discharged as anger," McDaniel says. "Emotional reactions to illnesses like diabetes are totally normal. Being scared and angry and wondering what is to blame happens to everybody. It happens to family members as well as to patients. That is really important for people to expect. But they should know that it will get better. They will find a place for their feelings and for the illness."

    Two basic things have to happen. Everybody in the family needs to feel that they matter -- that what they are doing is helping. And everybody in the family needs to feel that the meaning they make of the experience connects them to one another.

    Family Teamwork

    This works best when the family pulls together as a team, Fisher says. He lays out four basic rules:

    • Respect differences of opinion, and resolve them in a collaborative way.
    • Acknowledge differences of beliefs between spouses.
    • Have empathy for what it is like to be the spouse of a patient.
    • Respect the patient.

    Jacobson says it's important for families to know what it is they're up against -- and to know that they aren't the only ones struggling with type 2 diabetes.

    "What they are combating is a combination of biology and culture," he says. "The biology is that when we were designed, we were clearly made to meet the problems of having too little food. Having the capacity to store food was a benefit. Now that conflicts with our fast-food culture. It is a tremendous disadvantage."

    Families soon find that it's not at all easy to make the changes now imposed on them. This generates anger.

    "It is important for families to realize what they are working against. They have to realize that to make change they need as powerful a team as they can muster. They are in it together," Jacobson says. "There is no simple, quick solution. Maybe someday there will be a pill to take to make sure you are no more than 10% over your best body weight -- but now it is a matter of diet and exercise."

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