When one-half of a couple has diabetes and the other doesn't, the challenge of how to "share" this experience becomes an issue that needs to be acknowledged and addressed. Not addressing it is to open the relationship to potentially damaging resentment and fear as well as missing out on some wonderful, relationship-deepening intimacy.
In most cases diabetes treatment tends to focus on the individual and his/her medical issues. It's important to realize that comprehensive diabetes management should include everyone important in the patient's life – especially partners and spouses. Interestingly, studies have shown that if things are okay at home, you're more likely to have A1cs that are in target zone. However, too often the assumption is made that if you're handling diabetes medically then you're doing okay in the interpersonal communications and quality-of-life departments as well. Talking about feelings related to diabetes with your spouse or mate can make even a good relationship better.
This is really about trust. For those of us with diabetes, it's difficult to let go. We probably have been told at some point in our "diabetes career" that we can manage this by ourselves. However, a lot of us have taken that to the extreme, developing coping and managing styles that, over time, say: "I can do it by myself – I don't need anybody else." Partners feel left out if there isn't a role for them to play in this important area of your life. It helps to remember that when our partners see us struggle with the inherent difficulties of daily management it usually brings out a genuine desire to help us in some meaningful way.
Spouses left out of the education/management loop can feel like their partners don't trust them enough to have them involved. Or that they're being left out of something really important. And the fear that the person with diabetes may have is that if they ask their partner to help they may help too much. You may not want to be a burden to your partner or you may be afraid that they'll think you are one! Or some well-meant suggestions may feel critical or judgmental. You might also be thinking that it's hard enough to deal with bringing a high number down and balancing food and exercise, let alone having to consider how another person feels about being left out!
Sometimes the burden of having to explain everything from the beginning – what is diabetes, what you have to do to manage it – is difficult and makes it easy for you to put off educating your partner. It's important that you both take time out of your busy schedules to fit this in. Your physician and diabetes educator would love to help you start the process.
From my own personal experience of living with type 1 for 43 years and from working with couples and families for 29 years, I realize that this is easier said than done. For some it's actually frightening. But walking through the fear with the hope of working together better is really worth it. Many couples that do address these issues usually realize a much deeper and expanded sense of intimacy and trust with their partners.
Going together to a diabetes clinic visit marks the beginning of a process of opening up to each other regarding diabetes because it sends a clear message to each of you that you're in this together-physically and emotionally. Schedule an educational session with your certified diabetes educator where your partner can learn about the basics of what diabetes is and how to manage it. This works better than you doing all the teaching for a few reasons. One, your spouse can ask questions without being worried about sounding silly or repetitive. Two, sometimes it's a lot easier asking a trained, objective professional questions as opposed to the person who you brush your teeth with! And three, it will give you some perspective on where your spouse is coming from when you hear the questions they ask.
Working out how much hands-on help you want and need and when you need it is also important. The underlying message of being open to mutual support and understanding will help guide both of you in this part of the process. Talk about questions like:
• Do you want or need help figuring out how much extra insulin to take every time your blood is over 300? • If you see your partner showing symptoms of low blood sugar should you say something or trust that they know and that they'll handle it on their own? • Will helping your partner with a low make them think that you think they can't handle it effectively?
While these issues may seem trivial, to not acknowledge them is to ignore the larger issue of making a plan of how to work together.
The person without the diabetes needs to recognize that they don't have to help you with everything! They need to recognize that you've managed to cope with the technical aspects of management for a long time without them. What you're looking for is a way for the two of you to both give and get. To not ask for help can make the other person feel left out. And giving too much help can make your partner feel suffocated. It's a balancing act that requires courage, sensitivity, empathy, and real love. A love that is fully awake to the importance of having some boundaries, both having respect for each other's privacy and a genuine desire to come together in a mature way; knowing that the whole is greater than the sum of the parts. And although the process can be difficult, once on this journey you'll be amazed at the gifts that you both give to and receive from each other.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
Last Modified Date: February 14, 2014
All content on dLife.com is created and reviewed in compliance with our editorial policy.
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Janis Roszler MSFT, RD, CDE, LDN
Janis Roszler, MSFT, RD, CDE, LD/N is the American Association of Diabetes Educators' 2008-2009 Diabetes Educator of the Year. She is a certified diabetes educator, marriage and family therapist, and registered dietitian. Her books include Sex and Diabetes (ADA) Diabetes on your OWN Terms (Marlowe & Co) and The Secrets of Living and Loving with Diabetes (Surrey books).
Donna Rice MSW, BSN, RN, CDE
Donna Rice MBA,RN,CDE,FAADE is the 2007 Past President of the American Association of Diabetes Educators. She is a registered nurse, diabetes educator and has developed numerous educational programs on sexual health and wellness. She is the co-author of Sex and Diabetes (ADA) and Diabetes and Erectile Dysfunction - A Quick ‘n' Easy Handbook For the Diabetes Educator (Bella Vita). Her newest publication is a children's book, The Magic is Me (Searchlight Press).