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    Type 1 Diabetes Puts Strain on Marriage

    Two Questions continued...

    Indeed, hypoglycemia emerged as a primary concern, despite the fact that none of the patients were unaware of the problem or were at any greater risk for hypoglycemia than is typical of type 1 diabetes.

    Partners in particular described “significant worry, stress, and anxiety about hypoglycemia and frustration in trying to prevent or manage it, e.g., the need to carry snacks, to remind and check during lows, and prearrange for emergencies,” the researchers write.

    Worry about future complications was a second major concern, with patients expressing the need for support without blame from their partners. Other challenges that emerged in the discussions included issues around exercise and weight control and “wrestling with insurance companies.”

    “The cumulative toll of management may be more than the sum of individual stressors,” Trief and her colleagues write.

    On a more positive note, participants often mentioned the benefits of technology, including insulin pumps and continuous blood sugar sensors. Most mentioned the improvements in quality of life from these devices, such as greater freedom and decreased burden of multiple injections.

    However, in some cases the technology made the partner feel less involved with the patient's self-care, with some not knowing how to work the devices or what to do if there was a problem. “That kind of surprised me, though it wasn’t necessarily negative,” Trief says.

    Future Research

    Trief says this preliminary information serves as a springboard for further research.

    In the meantime, she advises doctors: “If you’re thinking of understanding the whole patient, that means understanding their relationships.”

    To see a version of this story for physicians, visit Medscape, the leading site for physicians and health care professionals.

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