Romantic Relationships Among Emerging Adults With and Without Type 1 Diabetes.

We compared the romantic relationships of emerging adults with type 1 diabetes to those without type 1 diabetes. We examined whether there were group differences in romantic relationships and relationship quality and whether aspects of romantic relationships were connected to psychological and diabetes health. Emerging adults (mean age 27 years) with (n = 88) and without (n = 99) type 1 diabetes took part in the study. Participants completed an online questionnaire that assessed romantic relationships, psychological health, and diabetes health. Results showed that males with type 1 diabetes were significantly less likely than males without diabetes and either group of females to be involved in a romantic relationship. Among those in a relationship, there were no group differences in relationship quality. For both groups, being in a relationship was associated with less loneliness and greater life satisfaction. Among those in a romantic relationship, the quality of the relationship was more strongly related to psychological outcomes for those with than for those without diabetes. There was modest evidence that relationship quality was linked to better diabetes outcomes. When partner supportive and unsupportive diabetes interactions were examined, there was more evidence that unsupportive interactions were harmful (i.e., related to worse psychological and diabetes outcomes) than there was evidence that supportive interactions were beneficial. These findings underscore the importance of romantic relationships for health among emerging adults in general and suggest that there may be an even greater impact for those with type 1 diabetes.

Partner Involvement in Type 2 Diabetes Self-Management: A Mixed-Methods Investigation.

Researchers have recognized the role of social environment in diabetes management, with substantial attention directed toward spouses or romantic partners of people with diabetes. However, the specific ways in which partners are involved have not been articulated. This study, which included 207 couples in which one person was recently diagnosed with type 2 diabetes, used a mixed-methods approach to assess types of partner involvement in diabetes management. First, different types of partner involvement were qualitatively identified from audio-recorded interviews, and links between qualitative findings and demographics were examined. Next, qualitative codes were compared with quantitative measures of partner involvement. Finally, relations of qualitative codes to relationship quality and diabetes outcomes were assessed. Qualitative analyses identified three ways in which partners were involved in diabetes management (support provision, collaboration, and controlling behavior) and two ways in which they were not involved (independent coping and disengagement on the part of the person with diabetes). Participants with diabetes perceived less partner involvement than their partners. Comparisons with quantitative measures revealed that collaboration was distinct from partner support. Reports from participants with diabetes of collaboration, but not partner support, were connected to higher relationship quality and lower A1C, whereas partner reports of collaboration were related to better self-care. Diabetes disengagement was associated with poorer relationship and behavioral outcomes. These findings underscore the varied ways in which partners are and are not involved in diabetes management and suggest that collaboration is more beneficial than social support in terms of relationship quality and diabetes outcomes.

A Closer Look at Racial Differences in Diabetes Outcomes Among a Community Sample: Diabetes Distress, Self-care, and HbA1c.

OBJECTIVE: Approximately 34 million people in the U.S. have diabetes. With this illness come substantial changes to psychological and physical health. However, type 2 diabetes disproportionately affects non-Hispanic Black compared with non-Hispanic White populations. The purpose of this study was to examine racial differences in psychological, behavioral, and physical health over time among individuals recently diagnosed with type 2 diabetes. RESEARCH DESIGN AND METHODS: Data were collected from a community sample of 193 adults recently diagnosed with type 2 diabetes (44% female; 45% Black). Measures of distress, self-care behaviors, and HbA1c were taken at an initial interview (time 1) and 6 months later (time 2). Individuals wore an Actical accelerometer to assess physical activity and participated in three 24-h dietary recall interviews to assess dietary intake within 2 weeks of the initial interview. RESULTS: From time 1 to time 2, Black women showed the highest increase in depressive symptoms. There was a greater increase in regimen and physician distress among White compared with Black participants. White men and Black women reported a decline in medication adherence over time. There were no racial differences in changes in physical activity across 6 months. However, Black individuals had higher overall calorie consumption with greater protein, saturated fat, and cholesterol intake than White individuals. There were no race or sex differences in changes in glycemic stability. CONCLUSIONS: Initial adjustment to a diagnosis of type 2 diabetes differentially influences Black and White men and women in terms of depressive symptoms, diabetes distress, and self-care.

Daily Communal Coping in Couples With Type 2 Diabetes: Links to Mood and Self-Care.

Background: Adjusting to the challenges of a chronic illness does not affect patients alone but also influences social network members-most notably spouses. One interpersonal framework of coping with a chronic illness is communal coping, described as when a problem is appraised as joint and the couple collaborates to manage the problem. Purpose: We sought to determine whether daily communal coping was linked to daily mood and self-care behavior and examined one potential mechanism that may explain these links: perceived emotional responsiveness. Methods: Patients who had been diagnosed with diabetes less than 5 years ago and their spouses (n = 123) completed a daily diary questionnaire that assessed communal coping and mood for 14 consecutive days. The patients also reported daily self-care behaviors. We used multilevel modeling to examine the links of communal coping to patient and spouse mood and patient self-care. Because both patients and spouses reported their mood, the actor-partner interdependence model (APIM) was employed to examine mood. Results: Multilevel APIM showed that actor communal coping was associated with lower depressed mood, higher happy mood, and lower angry mood and partner communal coping was linked to higher happy mood. Patient communal coping was related to better dietary and medication adherence, and spouse communal coping was linked to better medication adherence. Perceived emotional responsiveness partially mediated the relations of communal coping to mood but not to self-care behaviors. Conclusions: Communal coping on a daily basis may help both patients and spouses adjust psychologically to the illness as well as enhance patient self-care behaviors.

Young Adults With Type 1 Diabetes: Romantic Relationships and Implications for Well-Being.

OBJECTIVE: The study goal was to examine whether young adults with type 1 diabetes involve romantic partners in their illness, and, if so, how their involvement is related to relationship quality and psychological well-being. METHODS: A total of 68 people (mean age 25.5 years, [SD 3.7 years]) with type 1 diabetes (mean diabetes duration 6 years, [SD 6.7]) involved in a romantic relationship (mean relationship duration 25 months, [SD 27 months]) completed phone interviews. Communal coping (shared illness appraisal and collaborative problem-solving), partner supportive and unsupportive behavior, relationship quality, and psychological well-being were assessed with standardized measures. The study was partly descriptive in identifying the extent of communal coping and specific supportive and unsupportive behaviors and partly correlational in connecting communal coping and supportive or unsupportive behaviors to relationship quality and psychological well-being. RESULTS: Descriptive findings showed that partners were somewhat involved in diabetes, but communal coping was less common compared to other chronically ill populations. The most common partner supportive behaviors were emotional and instrumental support. The most common partner unsupportive behavior was worry about diabetes. Correlational results showed that communal coping was related to greater partner emotional and instrumental support, but also to greater partner overprotective and controlling behaviors (P <0.01 for all). Communal coping was unrelated to relationship quality or psychological distress. Partner overinvolvement in diabetes management had a mixed relation to outcomes, whereas partner underinvolvement was uniformly related to poor outcomes. CONCLUSION: People with type 1 diabetes may benefit from increased partner involvement in illness. This could be facilitated by health care professionals.