“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!”
—Anonymous
According to the 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). The nation is also burdened with a large number of people with pre-diabetes (14% population). This means not only the individuals but 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 an adult, family members perceive it as a more serious condition than those affected by it so they are more fearful and worried.
The effects of a diagnosis of DM in a family member vary according to the age of the patient. When it is diagnosed in a child, the major brunt of the familial responsibility is borne by the parents, they may have to give up a job or other personal activities to divert more time to child care. It may force some to take up extra jobs to meet the financial burdens caused by the disease. Managing complications like hypoglycemia (low sugar), particularly when the child is at school or in the night, as well as sick day management of children with DM, poses a great strain on them. Parents of children with DM often experience various degrees of guilt both due to the diagnosis and the deviation from normalcy for the child and the siblings are affected by guilt, inattention, and certain restrictions imposed by the disease. Extended family pitching in with unsolicited advice and opinions often worsen the situation.
When an adult has diabetes, the spouse or partners face significant changes. It may lead to dealing with financial burdens to manage the disease and the 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. In an older couple, it may cause significant stress to the spouse who might be suffering from certain diseases and unable to support them adequately.
It is well-documented that the family plays a crucial role in managing many chronic diseases. A supportive family helps to accept the diagnosis and make the treatment easier for the patient by keeping him/her motivated to adhere better to medications, medical advice and maintain a positive frame of mind. Studies have also documented that unsupportive families can harm the patient by furthering feelings of inadequacy, guilt, and helplessness. So, the family gets affected and impacts DM management universally.
Here are a few tips to help families to face the battle against diabetes:
Knowledge: Arm yourself with facts about diabetes as myths lead to greater stigma, hurt, 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. Be in touch with your doctor to know more about how you can help.
Encourage healthy eating: Diabetes management needs healthy eating so make appropriate changes in the family meal plans. 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 consuming healthy food like whole grains, vegetables, fruits, low-fat milk products, lean protein sources, and healthy fat will go a long way.
Exercise together: Regular physical activity will help the patients to lose weight, lower blood sugar and improve their mental health. A realistic goal to achieve this is a half-an-hour of activity per day. Do it together be it walking, biking, yoga, exercises or enrolling in a gym.
Rest: Make sure that the patient gets enough sleep since it will make it easier to control blood sugar, be more alert, possess extra energy, experience less stress and have a more positive approach to the condition. Both high and low sugar can disrupt sleep.
Be observant to drop in blood sugar: Sometimes blood sugar 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 dizziness and difficulty in concentration. Be observant of these symptoms and take the required steps.
Don’t nag, be positive: The key to diabetes management is a behaviour change—not overeat, miss daily exercise, or forget to take medications—supported by a realistic goal setting. Family members should try to avoid using guilt to increase compliance in patients and encourage a positive attitude. 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.” If someone in the family has diabetes, see it as a challenge to be faced together!
The writer is endocrinologist and diabetologist at Max Hospital.