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Diabetes Discoveries & Practice Blog

Diabetes Diagnosis: A Teachable Moment for Partners

A couple cooking.

Partners of people with diabetes are at a significantly higher risk of developing diabetes themselves.

Research shows that partners of people with diabetes are at a significantly elevated risk of developing diabetes themselves. We suspect this is because of shared household risk factors associated with behaviors around nutrition, exercise, healthy eating, and active living habits.

While there hasn’t been a lot of research in this space, some research suggests that partners and spouses of people with diabetes are more aware of diabetes risk factors, such as knowledge about the disease, what leads to the disease, and what leads to complications from diabetes. So, if the partner of a person newly diagnosed with diabetes has more knowledge about this disease, how can we determine if that knowledge is getting translated into action for themselves?

If you look at research about partners or spouses of people with diabetes, it’s really through the lens of a caregiver:

If you look at research about partners or spouses of people with diabetes, it’s really through the lens of a caregiver:

  • “How is the partner supporting the person with diabetes?”
  • “How is the partner helping the person with diabetes achieve their diabetes-specific goals?”
  • “Is that stressful for the partner as a caregiver?”

However, what hasn’t been thoroughly examined is whether a diagnosis of diabetes affects the health behaviors of the patient’s partner, and how the diagnosis might expand beyond the individual with diabetes.

In our study, we wanted to see if partners of people with newly diagnosed diabetes changed their health behaviors compared with partners of people without diabetes. Are they learning more about health behaviors that can put them at risk for diabetes? Does a diagnosis of diabetes serve as a teachable moment or a wake-up call for the partner or spouse to think, “Oh wow, I’m eating the same things and I’m exercising about as often as my partner and she got diabetes. Maybe I should be thinking about this for myself.”

We reviewed the electronic health records of more than 180,000 co-residing couples who were members of Kaiser Permanente in Northern California from 2007 to 2011, and compared couples where one person had newly diagnosed diabetes to couples where nobody had diabetes. We discovered that partners of the people with diabetes, by comparison, had a significantly higher level of health-seeking behaviors, such as participation in wellness classes, as well as significantly higher testing levels for glucose, lipids, and blood pressure. They were also more likely to have an influenza vaccine.

Most surprising was the fact that the spouses of people with diabetes were more likely to have significant, clinically meaningful weight loss. That’s quite a change. And the real surprises were that in almost every behavior category examined, the spouses of people with diabetes were more likely to have changed their behavior in a positive manner.

Potential Teachable Moments

We don’t know exactly why a diabetes diagnosis affects the health behaviors of a patient’s partner, but we have some thoughts based on the study:

  • Knowledge of Risk

    If someone you love develops diabetes, you’re likely to learn about the causes of diabetes and its complications, even if it’s just secondhand. The knowledge of risk seems to get translated into action, which is part of why we think it’s potentially a teachable moment for the partner.

  • Shared Health Behaviors

    When people are living together, they often share health behaviors. So, if a person with diabetes changes a behavior to improve their health, the behavior might also be taken up by their partner. A great example of this could be grocery shopping or menu planning. If a person with diabetes is cutting back on, for example, sugar or simple carbohydrates, or increasing their vegetable intake, it seems very likely that people they are living with might end up doing the same thing – whether they had intended to or not. I think future research should see if nutrition, cooking, or eating habits change even without any kind of intervention. Maybe even more importantly, what would happen if there were an intervention to help take this potentially teachable moment and help people in an entire family learn how to reduce the risk of diabetes and its complications.

Expanding Our Perspectives on Health Care

I’m not a clinician, but when it comes to the impact of a “teachable” moment, it’s possible that it’s related to how seriously someone takes a diagnosis or a health event. That is going to vary by individual. In my mind, that’s an important role for diabetes education, wellness coaching, and motivational interviewing – to work with the patient to help them achieve their health goals. I believe there is a role for education, motivational interviewing, and patient-centered goal-setting around diabetes. And for the loved ones and the people who live with a person with diabetes, this is an opportunity to improve their health, too, through some of those exact same mechanisms.

We usually think about a patient with a diagnosis as an individual unit. As we are treating that individual patient’s diabetes, we are trying to address that individual patient’s risk factors for complications, so we’re really thinking about one person at a time. To me, the implication of this research, both for health care professionals and for other professional researchers, is that maybe the unit we want to think about is bigger than that. Family and community-level factors play an important role in people’s health, and we need to expand our perspective in both how we address health care and how we think about framing health care research.

Editor’s Note:

This research, “Influence of a New Diabetes Diagnosis on the Health Behaviors of the Patient’s Partner,” was published in the July/August 2018 issue of the Annals of Family Medicine, which also features an editorial entitled, “Teachable Moments for Patients, Practices, and Systems."


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