Impact of diabetes on the family

Diabetes is a family disease. Why? Because when a person is diagnosed with diabetes, the whole family is involved with the person with diabetes, especially those who are closest.
In the initial phase of the disease, there may be greater physical and psychological fragility, which may be due to a period, more or less long, in which the person was subject to the evolution of the disease and its consequences such as weight loss, dehydration and the state ketonemic with loss of appetite and weight loss. This condition can happen mainly in type 1 diabetes, with greater relevance.

Help control stress and anxiety

The diagnosis can be accompanied by worries and stress as is often the case. The Institute for Patient- and Family-Centered Care conducted a study involving 5000 adult people with diabetes and concluded that the involvement of family, friends and co-workers is very important in the well-being of the person with diabetes and in the self-management of diabetes. disease (Baig, 2015).
We know that the diagnosis of diabetes can be a reason for stress and anxiety, in children and adolescents, diabetes can appear almost suddenly, but in adults it evolves slowly and treacherously, until the diagnosis is made. The treatment of diabetes should be concerned with reducing, mitigating this distress. Educating, transmitting knowledge to the person with diabetes about the disease can provide security and allow the tranquility that is necessary for an adequate treatment. The health team should reassure the person with diabetes, focusing on general and particular aspects of treatment (lifestyle and medications) and complications and ways to avoid them. It is advisable to extend education to family members.

Learning to control diabetes

Diabetes is a very "demanding" disease. Its treatment requires healthy eating, regular physical activity, self-surveillance, planning and organizing healthy living habits. The person with diabetes should be part of the team that treats him, seeking responsible autonomy - attention to glycemic variations and hypoglycemia (identification and prompt and effective treatment) and prevention of complications through tight control, appropriate to the age and associated comorbidities without forgetting that the person must have the best quality of life possible. It should not be forgotten that poor quality of life affects Diabetes ( American Diabetes Association ).

The emotional impact can be significant not only in the person with diabetes, but also in the family, especially those closest to them.

Several factors can contribute to feelings of anxiety: the diagnosis, the fact that it is a chronic disease (long term), the appearance of potential complications and the feared hypoglycemia.

It is essential to educate to clarify and have availability of attention in certain stages of the disease. The staff of the multidisciplinary team must always be available to increase the safety of the diabetic person.

Extending education to family members

The support and monitoring provided by the family can be more emphatically implemented in children, adolescents and the elderly, contributing to physical and psychological well-being, fostering optimism and hope for the future of people with diabetes. This family support can be reflected, for example, in accompanying consultations and treatments, or in the preparation and administration of treatment (insulin, medication) to avoid omissions, exchanges and confusions.

Dealing with the disease will not be easy, but it will be much better if the process is followed by family members. Baig (2015) emphasized several forms of family support: social and emotional support, follow-up consultations, help with treatment decisions, support to initiate and maintain healthy lifestyle habits (not smoking, not abusing alcohol, healthy eating, activity physical activity according to age, for example), help to overcome family routines, help with financial difficulties, with insulin injections, encouraging and avoiding forgetfulness and accompanying people on emergency trips.
The family also has other responsibilities for not “sabotaging” their duties: planning inappropriate meals for a diabetic, not trying with unadvisable foods, not questioning the need and usefulness of medications and disturbing treatment adherence.

Supporting and getting involved reduces illness-related conflicts

It is very important to provide family members with information about the disease and treatment options, to validate their experiences as caregivers, to teach how to handle the tasks that are part of disease management and to teach how to plan for the future. Family members, with this integration in treatment-related activities, can also reap benefits such as reducing psychological stress, improving their behaviors, increasing health literacy, preventing disease and fighting obesity.

In a study by Anderson et al. , in adolescents aged 10 to 15, it was demonstrated that parental involvement can be reinforced through an intervention integrated into the team's routine and contributes to a reduction of family conflicts related to diabetes, through observation and counseling without being declared protection .

Family support facilitates metabolic control

Metabolic control is influenced by several factors such as socio-cultural factors (family interaction and pressure from family members), psychological factors (depression, harmful behaviors, stress, nutritional disorders, fear of complications and social discrimination) and also other factors such as the myths and fears of insulin, the dosages of insulin, other non-insulin injectables, oral antidiabetics, the physical and hormonal evolution of the young person and his metabolism. The importance of family members as caregivers will contribute to the association that occurs with better metabolic control and prevention of complications. Family intervention can be done, in children and adolescents, through support and reinforcement of security. It is important to be vigilant about deviations in behavior that impair the control of diabetes and the prevention of complications. In the adult, family intervention can focus on supporting and enhancing security, counseling in particular cases and sharing knowledge about the disease. Family relationships can influence the management of diabetes (conflicts of opinion about measures to be taken in the nutritional field, for example).

Failure to resolve problems can be a risk indicator for complications. It is advisable that team members are aware of these problems in order to act at this level. Some family risk factors were identified in a study carried out by Fischer (2006) - low couple satisfaction, hostility and conflicts, excessive criticism, poor ability to solve problems, low family coherence and cohesion, poor family organization, doubts about diabetes and on the effectiveness of the team's recommendations.

The knowledge of family members about diabetes is very important, influencing adherence to treatment, compliance with dietary recommendations, demystifying insulin therapy, identifying complications and supporting surveillance, especially in children, adolescents and the elderly.