Friends and family may help counter diabetes stress

People with diabetes may have healthier blood sugar levels when they get lots of encouragement from family and friends to help them overcome the stress of managing their disease, a U.S. study suggests.

Researchers surveyed 308 veterans with diabetes who all had a person in their life – often a spouse or adult child – they leaned on for support managing their condition. Researchers focused on how stressed patients felt about their disease and how much friends and loved ones acknowledged patients’ feelings and praised their efforts to do things like eat right, exercise, take medications and check their blood sugar.

As expected, patients with the most emotional distress from managing diabetes tended to have higher blood sugar levels than people who didn’t feel much diabetes-related stress.

But when the most stressed people had a supporter in their corner who offered positive encouragement, they had healthier blood sugar levels that were similar to patients who didn’t experience much stress.

“High levels of diabetes related distress can cause people with diabetes to feel overwhelmed and powerless in their ability to manage their diabetes,” said lead study author Aaron Lee of the VA Ann Arbor Center for Clinical Management Research in Michigan.

“These thoughts and feelings can undermine the daily efforts needed to manage diabetes, such as taking diabetes medications, exercising, eating a healthy diet, and checking blood (sugar) levels,” Lee said by email.

Helping patients overcome these feelings requires more than just good intentions. Friends and family members also need to say the right things.

Nagging, criticizing and blaming patients for their failure to manage diabetes well can often backfire, and make matters worse, Lee said. Instead, loved ones should offer what’s known as “autonomy support,” which praises good efforts and supports patients’ self-care choices.

“Our research indicates that how people support family and friends with diabetes may be just as, or more important than, how much support they provide,” Lee said.

At the start of the study, participants were 66 years old on average. Almost all of them were male, and most were white.

They typically had poorly controlled diabetes, based on blood tests that show the percentage of hemoglobin (a molecule on red blood cells) that is coated with sugar. So-called hemoglobin A1c levels reflect average blood sugar levels over about three months. Readings above 6.5 signal diabetes, and during the year-long study participants had average readings of 7.9.

Participants had moderate levels of stress about managing their illness, based on questionnaires asking them to rate their emotional distress from on a scale from 1 (not a problem) to 6 (a very serious problem).

When they didn’t have much support from family or friends, each one-unit increase on the distress scale was associated with a 0.2 increase in A1c readings during the year.

But when participants had lots of the right kind of encouragement, increased stress was not linked to any meaningful spike in A1c readings.

The study wasn’t a controlled experiment designed to prove whether or how support from friends and family might directly impact A1c readings.

It also focused on a narrow subset of the overall population with diabetes – white men who served in the military – and it’s possible the results might be different for women, or people from other racial or ethnic groups, researchers note in Diabetes Care.

Still, the findings add to growing evidence suggesting that the right kind of help from family and friends can make a big difference to patients living with diabetes as well as other chronic health problems like cancer or heart disease, said Dr. Pouran Faghri, director of the Center for Environmental Health and Health Promotion at the University of Connecticut in Storrs.

“This present study is in agreement with previous research that emotional support from family members may alleviate the emotional and physical distress related to the disease and help the person with diabetes better manage their chronic condition,” Faghri, who wasn’t involved in the study, said by email.

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