A new Diabetic Medicine study reveals that couples interventions may have beneficial effects for partners of individuals with type 2 diabetes. The study was a three-arm randomized telephone intervention trial comparing outcomes of couples calls (CC), individual calls (IC), and diabetes education calls (DE). While the focus of the trial was on diabetes outcomes for the patients, the authors also assessed whether partners who participated in derived benefit.
Compared with partners in the IC and DE groups (who were not involved), CC partners (who were actively involved to promote collaboration and communal coping) had greater reductions in diabetes distress (the worries and stress they feel because their partner has diabetes), greater increases in marital satisfaction, and some improvements in diastolic blood pressure.
There were no significant group differences in weight loss, or in changes related to diet and activity that might foster weight loss, suggesting that these behaviors would need to be directly targeted at partners to help them change.
"Providers often worry about engaging partners, for fear they will become a member of the 'diabetes police' and cause tension in the relationship. We found that involved partners benefited emotionally, and also felt better about their relationship, as they worked together to deal with the challenges of diabetes," said lead author Dr. Paula Trief, of SUNY Upstate Medical University.
Type 2 diabetes
The Diabetes Support Project was a three?arm randomized telephone intervention trial comparing outcomes of couples calls (CC), individual calls (IC) and diabetes education calls (DE). Couples included one partner with Type 2 diabetes and HbA1c ≥ 58 mmol/mol (7.5%).
All arms received self?management education (two calls). CC and IC arms participated in 10 additional behavior change calls. CC included partners, emphasizing partner communication, collaboration, and support.
Blinded assessments were performed at 4, 8 and 12 months. Partner outcomes were psychosocial (diabetes distress, relationship satisfaction, depressive symptoms), medical (BMI, blood pressure) and behavioral (fat intake, activity).
Partners’ (N = 268) mean age was 55.8 years, 64.6% were female and 29.9% were from minority ethnic groups. CC (vs. IC and DE) partners had greater reductions in diabetes distress, greater increases in marital satisfaction (4 and 8 months), and some improvements in diastolic BP.
There were no consistent differences among arms in other outcomes. There was no evidence of a dietary or activity behavior ripple effect on untreated partners, i.e. comparing partners in the IC and DE arms.
Collaborative couples intervention resulted in significant improvements in partner diabetes distress and relationship satisfaction. There were no consistent effects on behavioral or medical partner outcomes, and no evidence of diet or activity behavior ripple effects, suggesting that partners should be targeted directly to achieve these changes.