New Study Finds Benefit in Couples Therapy for Individuals with T2D

Managing and living with diabetes is often a full-time job. Demands of life with a chronic illness can become overwhelming and defeating. Not only can depression lead to diabetes, but diabetes can also lead to the development of depression—a no-win cycle. Surveys have found that many individuals with diabetes feel they lack the support system and understanding they need to face their condition head-on and complete treatment regimens and self-care tasks required of T2D management. This can lead to feelings of despair and exasperation that can be hard to overcome without help.

A recent study authored by Paula M Trief, PhD, of SUNY Upstate Medical University, Syracuse published in Diabetes Care at the end of last month, highlights the potential health benefits of engaging non-diabetic individuals in the care and support of those with T2D. A total of 280 couples, with one partner having poorly controlled T2D (HbA1c levels of 7.5% or higher) who had been together on average 25.5 years, participated in a 12-month, randomized, controlled study. In the study, couples were randomized into three groups; a couples behavioral intervention group, an individual intervention group, and an individual diabetes education group.

Each group received two 75-minute phone calls that consisted entirely of diabetes management and care information. The education group received no other phone calls, while the couples call group and the individual behavioral intervention group received 10 more roughly one-hour phone calls centering around medication adherence, goal-setting, behavioral contracting, diet and activity changes, blood glucose monitoring and self-monitoring. For the couple intervention group, both partners participated in the calls, and additionally, were encouraged to focus more on mutual support, solving problems cooperatively, conflict management, communication techniques, and recognizing the impact they had on one another.
The mean baseline HbA1c level for the patients was 9.1%, and significant reductions in HbA1c levels were observed for all groups (most likely indicative of the power of educating those with very uncontrolled T2D). However, for patients in the middle tertile of HbA1c levels (8.3%-9.2%), representing the majority of individuals with T2D that clinicians see and treat, HbA1c levels were significantly lower after one year only for the group receiving couples’ behavioral intervention. Several other positive health changes, such as lowered body mass index, decreased waist circumferences, and decreased blood pressure were present in the groups receiving behavioral intervention of either kind, however, the couples group saw significant benefit on other psychological measures than their counterparts.

Those partaking in couples intervention reported significantly lower diabetes distress, reduced depression scores, and incredibly high levels of care satisfaction. Knowing that T2D can bring along with it many potential psychological effects, or feelings of depression and loneliness, these results can indicate that engaging spouses or partners in an individual’s care can do more than anticipated. Improved psychological health can only lead to an increased ability and desire to participate in self-care and positive behaviors that can aid in the control and management of T2D, while also improving and fostering stronger relationships. It may seem hard to connect with others and feel like your struggles with T2D are understood. Even if you feel your partner, family members, or friends don’t provide you with the support you need, always remember, you are not alone, and online communities like ours can be a great outlet for help!1

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