IN THIS CHAPTER
Receiving support from family and friends
Knowing how to be supportive
Diabetes touches almost everyone in the United States today. You’d be hard-pressed to find someone who doesn’t have a relative, neighbor, or friend with type 2 diabetes. You may have diabetes yourself, or you may be caring for someone with diabetes. Either way, diabetes affects all of us in profound ways, especially families.
Diabetes is a family disease for several reasons. Type 2 diabetes runs in families, so you’re more likely to have diabetes if your mother, father, or sibling has it. Obesity also runs in families, so you’re more likely to be overweight if you have a sibling or parent with extra pounds. Having an overweight spouse may also increase your chances of being overweight. You’re more likely to develop type 2 diabetes if you’re overweight or obese.
As important as the genetic factors are, the entire family feels it when just one person has diabetes. Diabetes doesn’t happen in a bubble — and you can’t take a pill to cure it. Instead, you must make daily changes to your lifestyle and health to manage type 2 diabetes. Family members, including spouses, are keenly aware of the changes that come with type 2 diabetes, whether they’re fluctuations in mood, new medication routines, or stresses associated with food and exercise.
Learning to communicate effectively as someone with diabetes or as a spouse or relative of someone with diabetes is important. In this chapter, we provide tips for educating your family about your diabetes. Caregivers and spouses, there’s a section for you, too. You find out the best ways to offer support and encouragement to your loved one with diabetes. We specifically discuss helping children and teens manage their type 2 diabetes in the next chapter.
Turning to Your Family for Support
Your family can be a fantastic source of support, or it can feel like they’re bringing you down. More likely, it’s something in between. We love our families, but they can be frustrating sometimes, too!
Realizing that you’ll need to take your family into account when you have diabetes may be one of the first steps in seeking support. Other key elements include: education, communication, and eating healthy foods and exercising together.
Telling your friends and family about your diagnosis
There isn’t a rule for which people to tell about your diabetes, although most people would agree that telling your spouse or partner is important. You might also consider telling people with whom you live closely such as roommates or your best friend. A good rule of thumb may be to tell people who can offer support and help you navigate diabetes. More support can help you manage your diabetes, and cope with the inevitable frustrations and problems that can come up.
You can be fairly straightforward in your description when talking to a friend or loved one: “I found out that I have type 2 diabetes, and I’m taking steps to manage my blood glucose by eating healthy, exercising more, and taking medications.” Be prepared for questions — or silence. Some people may have tons of questions about diabetes and how it impacts you. Other people may not know what to say in that moment. Feel free to tell that person that you’re learning about diabetes as you go, too.
Educating your family
Your family may need to learn about diabetes just as you had to learn about diabetes when you were diagnosed. They may not know anything about the cause, diagnosis, management, or treatment of diabetes. Or they may have preconceptions about diabetes that aren’t accurate or fair. They may be scared about complications, just as you may be.
Educating your family about diabetes is a way to open up a conversation. Each member of your family should understand what diabetes is, how it’s managed, and how to handle emergencies.
Feel free to tell them about diabetes in your own words or encourage them to seek out their own resources. Websites that educate about the basics of diabetes such as the American Diabetes Association’s website (www.diabetes.org) are great places to start. Books like this one or magazines such as Diabetes Forecast are other good tools. Online message boards are another source of education and support.
If you feel comfortable, ask a family member such as a spouse or sibling to go with you to your next healthcare appointment. Together or separately, keep a running tally of questions or concerns to bring with you when you visit your physician.
Consider bringing a family member to a diabetes education class so he or she can hear about the basics of diabetes and the steps you’ll be taking to manage diabetes through healthy eating, exercise, medications, and checking your blood glucose. Many diabetes education classes encourage family members to attend.
Emergencies are another topic that you’ll want to talk about with your family. Tell your family members about hypoglycemia — as well as its warning signs. (See Chapter 8 for details about hypoglycemia.) Sometimes you may not realize that you’re having a low blood glucose level, but your family members may pick up on mood changes and/or fatigue, which can signal a low. Make sure they know what to do if you’re having a low, such as making sure you get an appropriate snack or glucose gel.
Opening the lines of communication
An open flow of communication is important for all families, but particularly for ones navigating diabetes. Recognize that mood changes and stress are common symptoms of managing a chronic condition such as diabetes. Talking about your feelings may help you, as well as the people closest to you, feel better.
You may occasionally feel grumpy because of your diabetes or because of all the things you have to deal with on top of your diabetes. These feelings are normal, so try to give yourself a break, and ask your loved ones for extra empathy on those days.
Some family members may show their concern by frequently asking you about your diabetes or reminding you to do certain things. Some people may go so far as to tell you what you should and shouldn’t do. These folks are sometimes referred to as the “diabetes police.”
If you feel like your family members are being pesky, gently tell them how you feel. Choose a less-heated moment or a time when you and the other person are both relaxed to bring up the topic. Tell them you understand that they’re concerned about your health and behaviors; however, you feel like the frequency or tone of their comments and suggestions aren’t helpful.
Making healthy food choices together
Choosing healthy foods can be a family affair. After all, everyone needs to eat more wholesome, nutritious foods. You may want to explain to your family that there isn’t a special diet that people with diabetes must follow. Instead, people with diabetes should choose healthy foods that are good choices for anyone.
Keep in mind that making food changes can be challenging for individuals — and families. Your family or spouse may be resistant to change if you’ve been eating a certain way for years (or even a lifetime).
Explain to your family why you’re making the changes and ask for their support. If you’re the person in charge of meal planning for the family, tell them about the changes you want to make, such as eating more vegetables and whole grains. Ask for their input about what kinds of healthy foods they enjoy and include these foods in new recipes. No one wants to feel like they’re being forced to eat certain foods, so giving your family options could alleviate friction.
You may be frustrated when you have to eat smaller portions or cut out certain foods that your spouse or family members enjoy. It can be a real source of tension! Talk to them about these frustrations and ask whether they can be accommodating. It may mean asking them to enjoy less-healthy foods at other times rather than during family meals.
Eating differently may be one of the hardest parts of managing your diabetes, so explain this to your family and ask for their support. Know that eating healthy is good for you and sets an excellent example for your children, spouse, and others. (See more about healthy eating in Chapters 11 and 12.)
Cookbooks such as Diabetes & Heart Healthy Meals for Two by the American Diabetes Association and American Heart Association offer recipes that you and your loved one can enjoy together. Other cookbooks that specifically address occasions such as family gatherings and holidays may also offer new recipes. And a meal-planning guide or cookbook such as The Six O’Clock Scramble Meal Planner or Quick Diabetic Recipes For Dummies (Wiley) can help mothers and fathers cook healthy meals for the whole family.
Exercising together
Exercising is a good way to get your family onboard with your diabetes plan. Just like healthy eating, exercise is good for everyone. And it’s one of those things that you can’t enjoy too much.
Ask a family member, such as your spouse or significant other or teenage son or daughter, whether he or she would like to join you in exercise. Sometimes an invitation is the best starting point: “Do you want to take a walk with me?” Don’t take offense if someone says no. Leave the door open for future participation. However, if someone says yes, then you’re off and running (or walking). Having a buddy can be tremendously helpful when starting a new exercise regimen. (See more about exercise in Chapter 13. Also consider picking up a copy of Diabetes and Keeping Fit For Dummies [Wiley] for workout routines and fun activities to help you get and stay in shape.)
Planning family activities that involve physical activity will also boost your own fitness. A bike ride, hike, or just hitting a round of putt-putt can be fun adventures for everyone. Turn off the TV and have a dance party or head outside and garden together.
Tips for Caregivers and Spouses
Spouses and caregivers have the unique role of supporting someone with diabetes. The key is, in fact, support. You want to be as supportive as you possibly can for your loved one. Sometimes the way to be supportive may not always be clear, but we give you some tips for navigating this road in the following sections.
Educating yourself
Education is integral to offering meaningful support. You have to understand what you’re dealing with before you can jump in and offer your assistance.
Find resources for learning about diabetes by looking online at www.diabetes.org or other websites. Check out books from the library or order a subscription to magazines such as Diabetes Forecast (www.diabetesforecast.org) for you and your loved ones. Find recipes online or read cookbooks about diabetes that will help you plan healthy meals for you and your loved ones.
Ask whether you can attend a diabetes education class with your loved one. Seek out community resources such as local health fairs or the American Diabetes Association’s Diabetes Expo where you can learn about diabetes from experts.
Be patient with yourself and recognize that you’ll experience a learning curve. The education may seem overwhelming at first, but allow yourself time to learn and to breathe. Your spouse or loved one may be experiencing the same feelings.
People with diabetes can have health issues related to sex such as erectile dysfunction; difficulty with arousal; or pain during intercourse (see Chapters 9 and 10 for more details). If you’re a partner of someone with diabetes, these issues can certainly affect you, too. Educate yourself about common sexual health issues and be open to discussing them if they come up. Your partner (or you) may find these topics difficult to discuss, but talking about them is the first step. Effective treatments are available, so encourage your partner to bring up any concerns with his or her physician.
Trying not to be pesky
One of the most common traps that spouses and caregivers fall into is becoming the “diabetes police.” This term refers to individuals who try to monitor and dictate another person’s management of diabetes. Of course, the intent is good: You want to help your spouse or loved one make healthy choices about eating, exercising, or checking blood glucose. However, these suggestions can come across as nagging if they’re delivered too frequently or with a harsh tone.
Sometimes a spouse or family member of a person with diabetes will want to call healthcare professionals to offer information about the patient and request feedback. Generally, unless it’s an emergency call or the healthcare provider was given explicit permission to do so, he or she may not feel comfortable discussing the patient’s health without that person being present. However, the healthcare provider may be open to scheduling a conversation with both the patient and the family member(s). Always check with your loved one first before calling his or her healthcare providers.
As an alternative, ask your spouse or loved one for concrete examples of how you can be helpful. Start by asking, “What can I do to help you the most in managing your diabetes?” You may be surprised by the answer!
Helping to build a diabetes care team
Ask your loved one or spouse whether he or she would like help building a network of healthcare providers. This can be an overwhelming task in managing diabetes. Finding the right endocrinologist, podiatrist, dentist, or certified diabetes educator (CDE) isn’t always easy. An extra set of hands to schedule appointments and find specialists may be welcome.
You may want to ask whether you can attend appointments with your spouse or loved one. Sometimes it can be helpful to have someone else listening to a physician’s recommendations or asking pertinent questions. Write down your own concerns beforehand or work on a list of questions with your loved one so you remember your concerns and have time to address them during the appointment.
Seeking out your own support
As caregivers, spouses, and family members, we feel the stress of living with diabetes, too. It’s natural to feel overwhelmed by the daily demands of caring for someone else or the pressure and fatigue of worrying about your spouse’s health.
Seek out your own support group in your community or online. Other caregivers and spouses feel the same way you do, and talking with them may help relieve some of the stress or sadness you’re experiencing. Talk to a therapist or family counselor to get a professional’s perspective and advice on the demands of caregiving on relationships.