By Dr. Aishwarya Krishnamurthy
Diabetes is like a roller coaster – it has its ups and downs but it is up to you to scream and suffer or enjoy the ride! ~ Unknown
According to International Diabetes Federation, India has 77 million persons living with diabetes mellitus (DM) and has the second highest number of children with type 1 diabetes mellitus(T1DM). Additionally, the Nation is also burdened with a large number of those with pre-diabetes (14% of the population).
This means that not only the individuals but also their families are facing the effects of this lifestyle disease on their physical, mental, emotional and financial well-being. Whether the person affected is a child, adolescent or adult, other family members perceive it as a more serious condition than those affected by it so they experience more fears and worries.
The effects of a diagnosis of DM in a family member varies according to the age of the patient at the diagnosis of the disease. When DM is diagnosed in a child, the major brunt of the familial responsibility is borne by the parents. This could mean several things for a parent, like giving up a job or other personal activities in order to divert more time to child care, some may on the converse be forced to take up extra jobs to meet the financial burdens of the disease management. Managing complications like hypoglycemia (i.e low sugars), particularly when the child is at school or at night as well as sick-day management of children with DM poses great strain on the caregivers. Parents of children with DM, often experience various degrees of guilt both at the diagnosis as well as the deviation from “normalcy” for the child. In the Indian settings, this is often worsened by extended family pitching in with unsolicited advice and opinions. Siblings of the child with DM are also affected by guilt, inattention and restrictions imposed by the disease on the family.
When diabetes is diagnosed in an adult, the spouse or partners are the ones who face significant changes. This could mean dealing with financial burdens posed by the disease management as well as loss of employment of the patient for health reasons. There may be problems related to having a child in both men and women with diabetes which could directly affect the partner or spouse. Many think of it as a burdensome disease that one cannot control and frequently, there is some amount of blame game due to the myths and fallacies that surround diabetes e.g. eating sugar causes diabetes, poor self-control or laziness. In an older couple, it may pose significant stress on an older spouse who might themselves be suffering from diseases and unable to support them adequately.
On the flip side, it is well documented that the family plays a crucial role in managing many chronic diseases. A supportive family helps accepting the diagnosis and treatment that much easier for the patient at any age. It not only keeps the patient motivated to adhere better to medications and medical advice but also maintain a positive frame of mind while doing so. Studies have also documented that unsupportive families can harm the patient by furthering feelings of inadequacy, guilt and helplessness.
So, the family is affected by and affects DM management universally. Here are a few tips to help families to face the battle against diabetes, together with their loved ones.
Knowledge: Arm yourself with facts about diabetes. Myths about the condition lead to greater stigma, hurt and most importantly, misunderstanding and misdiagnosis. Teach yourself and some extended family members about blood sugar monitoring, lifestyle changes required and remember that each person with DM has different needs. Keep in touch with your doctor to know more about how you can help.
Encourage healthy eating: Diabetes management needs keen attention to healthy eating so check and make appropriate changes in the family meal plans. Eating healthy is beneficial to all irrespective of the presence of DM. It is more encouraging for the person with DM to stick to the diet when the entire family is trying. Limiting highly processed foods, sweets and fried foods and increasing healthy food choices like whole grains, vegetables, fruits, low fat milk products, lean protein sources and healthy fat in the family diet will go a long way in improving overall health of the family while helping persons with diabetes to adjust their eating.
Exercise together: Regular physical activity will help the patients to lose weight and lower blood sugar while contributing to their general mental health due to production of endorphins. A realistic goal to achieve this is a half-an-hour of activity per day, which can also be broken up into 10-minute segments. Provide companionship during this activity be it walking, biking, yoga, exercises or enrolling in a gym so that both benefits.
Rest: Make sure that the patient gets enough sleep since it will make it easier to control blood sugars, be more alert during day time, possess extra energy, experience less stress and have a more positive approach to the condition. Remember both high and low sugars can disrupt sleep.
Be observant to drops in blood sugar: Sometimes blood sugars may drop in persons with diabetes causing them to be shaky, nervous, irritable, impatient, sad, angry without reason, experience sweating or clamminess, weakness, hunger and may feel dizzy and find it difficult to concentrate. Learn to be observant of these symptoms and take necessary steps to test and take appropriate action to rectify the situation.
Don’t nag! Be Positive! The key to diabetesmanagement is a behavior change – Never to overeat, miss daily exercise or forget to take medications – supported by a realistic goal setting. Family members should try to avoid using guilt as a method to increase compliance in patients. Instead try and encourage a positive attitude for the same. Being kind and appreciating the efforts of each other will go a long way in beating the disease.
In the words of Victor E Frankel- “When we are no longer able to change a situation, we are challenged to change ourselves.”
The family should remember that life is not over because someone in the family has diabetes – look at it as a challenge to be faced together!