Living With Type 2 Diabetes Is Family Affair
Family involvement is crucial to diabetes control.
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
- 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."
Finding enjoyment is the solution.
"Pleasure in succeeding is needed, because you have to
replace the pleasure that food gave before," Jacobson says. "So if they
find pleasure in seeing a 5-pound weight loss or in exercising a few minutes
more than they could do before, that's the path to success. You can find
pleasure in gradual change."
It's also important not to get sidetracked by inevitable
setbacks. People, being human, will do better at some times and worse at
others. Families need to be prepared for the long term.
The good news is that small improvements make a big
"This is where biology is helpful. For people with
diabetes, relatively modest improvements in exercise and fitness are
helpful," Jacobson says. "You don't have to go from 55 pounds
overweight to perfectly normal. And the biology of medicine does give us some
help, with medicines that are helpful."
Diabetes is not an unmitigated disaster.
"Illness can be an opportunity for family relationship
healing," McDaniel says. "It can be an opportunity to work out
longstanding difficulties, now that it is clear that somebody is really
She recommends getting on the right track as soon as possible
-- soon after the diabetes diagnosis is made.
"My pitch is don't let it get to a disaster before you see
somebody like me," she laughs. "It is so much harder to dig out of a
huge number of abusive fights. When things just start to get derailed, it is
easier to deal with than when there's been a train wreck."