Family support is crucial for diabetes care

Dr Amitava Acharrya, CNS Correspondent, India
Photo credit: CNS (Durban, South Africa: 2017)
Human health is an equilibrium condition of physical, mental and social health. Traditionally, human beings are a group of socially dependent mammals where family and society have a major role in the development of human behavior, morality, ethics and the way of life. This becomes all the more pronounced in countries like India, where a strong traditional and cultural bond runs in its milieu.

The Indian family system takes the lead in developing a strong, stable, enduring system of bonding. Historically, a typical Indian family meant the joint family, where three to four generations, including uncles, aunts, nieces, nephews and grandparents, lived together under the same roof. However, over a period of time, societal upheavals, including rising aspirations fed with the economic boom, slowly paved the way for nuclear families, which have now become the order of the day rather than an exception. This social change has brought in its own merits and demerits.

The number of people living with type 2 diabetes is increasing (and so is its cost of treatment) in developed as well as developing countries. The management of diabetes can be relatively complex for patients. They need to have multiple physicians’ visits every year; adhere to several different types of medications to control their condition; and participate in many facets of self-care, including home glucose monitoring, healthy eating, and regular physical exercise. At the same time they have to negotiate many barriers—such as the high cost of care and balancing work and life commitments. 

It is a documented fact that type 2 diabetes is largely preventable through regular physical activity, a healthy and balanced diet, and a healthy living environment. Family care can go a long way in promoting all this and act as a stimulant for good diabetes control and care. Family members can participate in active support and care of those living with diabetes. A systematic review study highlights the importance of family, friends and colleagues in improving well-being and self-management of adult persons living with diabetes. The support from family members plays a crucial role in maintaining lifestyle changes and optimizing diabetes management.

Family members can provide many forms of support — instrumental support like driving patients to appointments and/or helping them inject insulin, and social/ emotional support in helping patients cope with their disease. Through their communicative skills and positive attitudes, family members often have a significant impact on the patient’s psychological well-being, adherence to long term medical treatment and ability to initiate and maintain changes in diet and exercise. Among middle-aged and older adults with type 2 diabetes, social support has been found to be associated with improved self-reported health in long-term follow-up. Another study found a direct relationship between psycho-social determinants of health and glycemic control. Higher family or social support has been found to be positively related to patients’ self-care behavior and to improvements in blood glucose control. In a study in Korean immigrants with type 2 diabetes, more perceived diet related family support was found to be significantly associated with better glucose control. Also, the positive impact of family support on glucose outcome was significantly stronger in men than in women.

Studies have also found that supportive and helpful behavior by family members in educational interventions has improved rates of smoking cessation and weight loss

Providing diabetes education to individuals with type 2 diabetes, without including the family, could limit its impact on diabetes control. Family-based educational approaches to chronic disease management are going to be the future treatment protocol in NCDs (like diabetes) and their risk factors’ management. Including family members in diabetes educational interventions may provide support to patients with diabetes, help to develop healthy family behaviors, and promote diabetes self-management. Family members may also benefit more directly by reducing their own psychological distress regarding their loved one’s diabetes and improving their own health seeking behavior by attending health education programs.  Furthermore, family members at high risk of diabetes are likely to decrease their own likelihood of developing the disease through improved lifestyles and behavioral changes.

The term ‘family’ is not confined only to blood relations. It is much more than that and extends from house to community; from playing ground to workplace. Let us come forward by helping each other for care of our beloved family members and take an oath to fight the demon of diabetes.

Dr Amitava Acharrya, Citizen News Service - CNS
May 20, 2019

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