Q: I've had type 1 diabetes since I was a kid (I'm now 42). It's well controlled, but lately I'm starting to be really anxious about complications. What can I do to save myself from all the scary things that can happen to me as I get older?
– Brooke
A: Let me start by congratulating you on controlling your blood sugar — it is extremely important to your health. The discipline with which you've controlled your type 1 diabetes thus far, and close collaboration with your doctor, will surely help reduce your risk of worrisome complications.
Over the last several years, a number of studies have shown us that diabetes-related complications are the consequence of both poor glucose control and conditions such as high blood pressure and high cholesterol. The latter are associated with advancing age, genetic risk, and an unhealthy lifestyle. As long as you continue to control your blood sugar, with close follow-up from your doctor, then concentrating on lifestyle factors is the best way to improve your odds of avoiding complications.
As you grow older, regular exercise and ideal body weight maintenance become increasingly important components of diabetes care, blood pressure control, and lipid (cholesterol) management. Having a sustained normal or near-normal glucose level, blood pressure below 120/80, and a low cholesterol level (low-density lipoprotein level below 100 mg/dl) will stave off bad outcomes.
Besides home glucose monitoring, keep track of your glycosylated hemoglobin (hemoglobin A1c) level. Levels below 7 percent are associated with reduced complications — I prefer maintaining this level closer to 6 percent. Other risk factors you can change through exercise and a healthful diet include a high triglyceride level and a reduced level of high-density lipoprotein (HDL-C). A triglyceride level below 150 mg/dl and an HDL-C level above 40 mg/dl are associated with better health outcomes.
As an adult over age 40, you might be able to take daily aspirin, which considerably reduces cardiovascular risk. Do seek the advice of your doctor on this and other specific treatment and monitoring recommendations. Most important, if you use tobacco, stop. Quitting smoking is the single most critical step you will ever take toward preventing many of the diabetes-related complications.
Tuesday, December 7, 2010
Monday, December 6, 2010
Why Are My Feet Swelling?
Q: Is it normal for your feet and ankles to swell, and can anything be done to stop it? I've noticed I begin to swell three days ago. The swelling does go down a little at night when I prop my feet up.
— Angela, Wichita
A:
Fluid retention is very common and the easiest way to diminish the swelling is by lowering your intake of salty foods (chips, fries, olives, fast-food items, etc.) and drinking plenty of water. You could also try wearing elastic stockings (also known as support or compression stockings), which can help stimulate circulation in your legs and stop swelling. If you spend all day on your feet, the stockings are probably your best bet for long-lasting relief.
Another option: Try elevating your feet even a few inches off the ground when you're sitting down. For example, keeping a small ottoman or stepstool under your desk at work and using it to prop your feet up can help reduce the swelling a lot. Finally, mild diuretics can help ease swelling in severe cases, but these are medications that your doctor will need to prescribe. The best idea is to discuss all of these options with your doctor, so the two of you can devise a plan together.
— Angela, Wichita
A:
Fluid retention is very common and the easiest way to diminish the swelling is by lowering your intake of salty foods (chips, fries, olives, fast-food items, etc.) and drinking plenty of water. You could also try wearing elastic stockings (also known as support or compression stockings), which can help stimulate circulation in your legs and stop swelling. If you spend all day on your feet, the stockings are probably your best bet for long-lasting relief.
Another option: Try elevating your feet even a few inches off the ground when you're sitting down. For example, keeping a small ottoman or stepstool under your desk at work and using it to prop your feet up can help reduce the swelling a lot. Finally, mild diuretics can help ease swelling in severe cases, but these are medications that your doctor will need to prescribe. The best idea is to discuss all of these options with your doctor, so the two of you can devise a plan together.
Depression, Diabetes Linked in Women
The link between diabetes and depression in women runs both ways....
According to Frank Hu, MD, PhD, of the Harvard School of Public Health, in a large prospective study, the risk of incident diabetes was increased for women with depressed mood, and the risk was higher if they were on antidepressant medications. Conversely, having diabetes increased the risk of incident depression over a decade of follow-up, and the risk rose with the severity of the disease.
The two-way association is partly explained by other known risk factors, such as adiposity and lifestyle variables, but is independent of them, Hu and colleagues reported.
The findings come from the Nurses' Health Study, a long-running cohort study started in 1976. For this analysis, the researchers looked at data from the participants starting in 1996, when questions related to clinical depression were first asked.
Hu and colleagues had information on 65,381 women, ages 50 to 75 in 1996, who were observed until 2006.
For the analysis of depression and incident diabetes, those with diabetes in 1996 or who were missing data on depression were excluded, leaving 57,880 women. For the study of diabetes and incident depression, 56,857 women were included, after leaving out those with depression at baseline, or who were either using or gave no information on antidepressant medications.
Hu and colleagues defined clinical depression as having diagnosed depression or using antidepressants, while depressed mood was either clinical depression or severe depressive symptoms, defined as a score of 52 or less on the five-item Mental Health Index. For the analysis, those with index scores of 86 through 100 were used as a reference group.
They confirmed self-reported diabetes using a supplementary questionnaire and medical record review. Participants without diabetes at baseline served as the reference group.
For depression and incident diabetes, they found:
There were 2,844 new cases of diabetes over the 10 years of follow-up.
Compared with the reference group, participants with Mental Health Index scores of 76 through 85, 53 through 75, or 52 and below had a monotonic elevated risk of developing diabetes, and the trend was significant at P=0.002 in the multivariate analysis.
Participants with scores of 52 or less had an adjusted relative risk of developing diabetes of 1.17, with a 95% confidence interval from 1.05 to 1.30.
Those using antidepressants were at higher relative risk after adjustment for covariates -- of 1.25, with a 95% confidence interval from 1.10 to 1.41.
On the other hand, the parallel analysis showed:
There were 7,415 new cases of clinical depression over the decade of follow-up.
Compared with the reference group, those with diabetes had a relative risk of developing clinical depression -- after controlling for covariates - of 1.29, with a 95% confidence interval from 1.18 to 1.40.
The relative risks rose with disease severity: 1.25 and 1.24 for those without medications or using oral hypoglycemic agents, respectively, and 1.53 for those on insulin. The associations remained significant after adjusting for diabetes-related comorbidities.
Hu and colleagues noted that the study's strengths include its large size and prospective design. On the other hand, much of the data was self-reported and the participants were registered nurses and most were white, so the results might not apply to different populations.
According to Frank Hu, MD, PhD, of the Harvard School of Public Health, in a large prospective study, the risk of incident diabetes was increased for women with depressed mood, and the risk was higher if they were on antidepressant medications. Conversely, having diabetes increased the risk of incident depression over a decade of follow-up, and the risk rose with the severity of the disease.
The two-way association is partly explained by other known risk factors, such as adiposity and lifestyle variables, but is independent of them, Hu and colleagues reported.
The findings come from the Nurses' Health Study, a long-running cohort study started in 1976. For this analysis, the researchers looked at data from the participants starting in 1996, when questions related to clinical depression were first asked.
Hu and colleagues had information on 65,381 women, ages 50 to 75 in 1996, who were observed until 2006.
For the analysis of depression and incident diabetes, those with diabetes in 1996 or who were missing data on depression were excluded, leaving 57,880 women. For the study of diabetes and incident depression, 56,857 women were included, after leaving out those with depression at baseline, or who were either using or gave no information on antidepressant medications.
Hu and colleagues defined clinical depression as having diagnosed depression or using antidepressants, while depressed mood was either clinical depression or severe depressive symptoms, defined as a score of 52 or less on the five-item Mental Health Index. For the analysis, those with index scores of 86 through 100 were used as a reference group.
They confirmed self-reported diabetes using a supplementary questionnaire and medical record review. Participants without diabetes at baseline served as the reference group.
For depression and incident diabetes, they found:
There were 2,844 new cases of diabetes over the 10 years of follow-up.
Compared with the reference group, participants with Mental Health Index scores of 76 through 85, 53 through 75, or 52 and below had a monotonic elevated risk of developing diabetes, and the trend was significant at P=0.002 in the multivariate analysis.
Participants with scores of 52 or less had an adjusted relative risk of developing diabetes of 1.17, with a 95% confidence interval from 1.05 to 1.30.
Those using antidepressants were at higher relative risk after adjustment for covariates -- of 1.25, with a 95% confidence interval from 1.10 to 1.41.
On the other hand, the parallel analysis showed:
There were 7,415 new cases of clinical depression over the decade of follow-up.
Compared with the reference group, those with diabetes had a relative risk of developing clinical depression -- after controlling for covariates - of 1.29, with a 95% confidence interval from 1.18 to 1.40.
The relative risks rose with disease severity: 1.25 and 1.24 for those without medications or using oral hypoglycemic agents, respectively, and 1.53 for those on insulin. The associations remained significant after adjusting for diabetes-related comorbidities.
Hu and colleagues noted that the study's strengths include its large size and prospective design. On the other hand, much of the data was self-reported and the participants were registered nurses and most were white, so the results might not apply to different populations.
Healthy Recipes Not Just for Diabetics
Healthy Recipes
Herbed Tomato Risotto Mix Recipe
Servings
Diabetes-Friendly
Nutritional Info (Per serving):
Calories: 80, Saturated Fat: 0g, Sodium: 276mg, Dietary Fiber: 2g, Total Fat: 0g, Carbs: 17g, Sugars: 0g, Cholesterol: 0mg, Protein: 3g
Exchanges: Starch: 1
Carb Choices: 1
Recipe Source:
Total Time: 10 mins
Ingredients
• 3 1/4 cup(s) rice, arborio, 2 12-ounce packages
• 3/4 cup(s) tomato(es), sun-dried, thin strips dried tomatoes or snipped (not oil-packed)
• 3 tablespoon minced onion, dried
• 1 tablespoon Italian seasoning, dried
• 1 teaspoon garlic, dried, minced
Preparation
1. In a medium bowl, combine uncooked rice, dried tomatoes, dried minced onion, Italian seasoning, and dried minced garlic. Divide mixture among 8 small resealable plastic bags (about 1/2 cup mixture per bag). Seal and label. Store at room temperature for up to 3 months.
To make Herb and Tomato Risotto:
In a heavy, medium saucepan, bring 1 1/2 cups reduced-sodium chicken broth to boiling. Add the contents of 1 bag of the Herb and Tomato Risotto Mix. Return to boiling; reduce heat. Cover and simmer for 20 minutes, adding 1 cup desired frozen mixed vegetables for the last 5 minutes of cooking. Remove from heat. Let stand, covered, for 5 minutes. After standing, rice should be tender but slightly firm. If desired, stir in 2 tablespoons grated Parmesan or Romano cheese. Season to taste with ground black pepper. Makes 4 side-dish servings.
Herbed Tomato Risotto Mix Recipe
Servings
Diabetes-Friendly
Nutritional Info (Per serving):
Calories: 80, Saturated Fat: 0g, Sodium: 276mg, Dietary Fiber: 2g, Total Fat: 0g, Carbs: 17g, Sugars: 0g, Cholesterol: 0mg, Protein: 3g
Exchanges: Starch: 1
Carb Choices: 1
Recipe Source:
Total Time: 10 mins
Ingredients
• 3 1/4 cup(s) rice, arborio, 2 12-ounce packages
• 3/4 cup(s) tomato(es), sun-dried, thin strips dried tomatoes or snipped (not oil-packed)
• 3 tablespoon minced onion, dried
• 1 tablespoon Italian seasoning, dried
• 1 teaspoon garlic, dried, minced
Preparation
1. In a medium bowl, combine uncooked rice, dried tomatoes, dried minced onion, Italian seasoning, and dried minced garlic. Divide mixture among 8 small resealable plastic bags (about 1/2 cup mixture per bag). Seal and label. Store at room temperature for up to 3 months.
To make Herb and Tomato Risotto:
In a heavy, medium saucepan, bring 1 1/2 cups reduced-sodium chicken broth to boiling. Add the contents of 1 bag of the Herb and Tomato Risotto Mix. Return to boiling; reduce heat. Cover and simmer for 20 minutes, adding 1 cup desired frozen mixed vegetables for the last 5 minutes of cooking. Remove from heat. Let stand, covered, for 5 minutes. After standing, rice should be tender but slightly firm. If desired, stir in 2 tablespoons grated Parmesan or Romano cheese. Season to taste with ground black pepper. Makes 4 side-dish servings.
Are You Diabetic and Want Something Healthy To Eat?
Healthy Recipes for those who are diabetic.
Tiny Broccoli Quiches Recipe
Quick Info:
Servings
Contains Wheat/Gluten
Contains Dairy
Contains Egg
Vegetarian
Diabetes-Friendly
Nutritional Info (Per serving):
Calories: 123, Saturated Fat: 3g, Sodium: 179mg, Dietary Fiber: 0g, Total Fat: 7g, Carbs: 9g, Cholesterol: 5mg, Protein: 3g
Exchanges: Starch: 0.5, Lean Meat: 0.5, Fat: 1
Carb Choices: 0.5
Recipe Source:
Prep Time: 45 mins
Cook Time: 25 mins
Total Time: 1 h 10 mins
Ingredients
• 11 ounce(s) piecrust mix (for 2-crust pie)
• 5 ounce(s) broccoli, frozen chopped
• 3/4 cup(s) cheese, Swiss, shredded
• 1 cup(s) milk, fat-free
• 1/2 cup(s) refrigerated or frozen egg product, thawed, or 2 whole eggs, beaten
• 2 teaspoon dill, snipped or 1 teaspoon dried dill
• 1/4 teaspoon salt
Preparation
1. Preheat oven to 400°F. Lightly coat thirty-six 1 3/4-inch muffin cups with nonstick cooking spray. Set aside.
2. Prepare piecrust mix according to package directions. On a lightly floured surface, roll dough to slightly less than 1/8 inch thick. Using a 2 1/2-inch fluted round biscuit or cookie cutter, cut dough into circles. Reroll scraps, cutting additional circles. Line each muffin cup with a pastry circle.
3. Pat broccoli dry with paper towels. Divide broccoli and cheese evenly among pastry-lined muffin cups. In a small bowl, combine milk, egg product, dill, and salt; spoon about 2 teaspoons of the milk mixture into each muffin cup.
4. Bake about 25 minutes or until puffed and set. Cool in pans on wire racks for 5 minutes. Loosen and remove from pans. Serve warm.
Tiny Broccoli Quiches Recipe
Quick Info:
Servings
Contains Wheat/Gluten
Contains Dairy
Contains Egg
Vegetarian
Diabetes-Friendly
Nutritional Info (Per serving):
Calories: 123, Saturated Fat: 3g, Sodium: 179mg, Dietary Fiber: 0g, Total Fat: 7g, Carbs: 9g, Cholesterol: 5mg, Protein: 3g
Exchanges: Starch: 0.5, Lean Meat: 0.5, Fat: 1
Carb Choices: 0.5
Recipe Source:
Prep Time: 45 mins
Cook Time: 25 mins
Total Time: 1 h 10 mins
Ingredients
• 11 ounce(s) piecrust mix (for 2-crust pie)
• 5 ounce(s) broccoli, frozen chopped
• 3/4 cup(s) cheese, Swiss, shredded
• 1 cup(s) milk, fat-free
• 1/2 cup(s) refrigerated or frozen egg product, thawed, or 2 whole eggs, beaten
• 2 teaspoon dill, snipped or 1 teaspoon dried dill
• 1/4 teaspoon salt
Preparation
1. Preheat oven to 400°F. Lightly coat thirty-six 1 3/4-inch muffin cups with nonstick cooking spray. Set aside.
2. Prepare piecrust mix according to package directions. On a lightly floured surface, roll dough to slightly less than 1/8 inch thick. Using a 2 1/2-inch fluted round biscuit or cookie cutter, cut dough into circles. Reroll scraps, cutting additional circles. Line each muffin cup with a pastry circle.
3. Pat broccoli dry with paper towels. Divide broccoli and cheese evenly among pastry-lined muffin cups. In a small bowl, combine milk, egg product, dill, and salt; spoon about 2 teaspoons of the milk mixture into each muffin cup.
4. Bake about 25 minutes or until puffed and set. Cool in pans on wire racks for 5 minutes. Loosen and remove from pans. Serve warm.
Sunday, December 5, 2010
Foot Pain at Night
Q:
I have neuropathy in my feet. It can be extremely painful at night, and it keeps me awake most nights. Is there any way to reduce the pain, and will this ever subside?
— Debbie, Wichita, KS
A:
Neuropathy is a painful and distressing complication of diabetes. In some people, it disappears on its own over a period of about 12 months. In others, however, it persists. There are medicines your doctor can prescribe to relieve your symptoms.
The U.S. Food and Drug Administration has approved two drugs, duloxetine and pregabalin, to treat the foot pain from diabetic neuropathy. Duloxetin is an antidepressant, and pregabalin is used to treat seizure disorders. Both have some side effects. Duloxetin can cause nausea, sleepiness, dizziness, decreased appetite, hot flashes, and constipation. Pregabalin can cause sleepiness and confusion and can also lead to dependence.
You might consider other kinds of treatment too, both traditional and not. In one Australian study, the antioxidant alpha-lipoic acid was shown to reduce pain. And other medications — including some antiseizure medications, antidepressants, and opiates — have been used with some success. Some people have used acupuncture, topical creams containing capsaicin (a substance found naturally in hot peppers), and other alternative therapies. Of course, many of these treatments have not been well studied enough to determine their effectiveness.
I would advise you to consult with your doctor to decide which treatment works best for you. It's important to remember, of course, that none of these medicines cure the underlying cause of neuropathy. That's why it's important to focus on tight glucose management. The basic problem that leads to neuropathy is nerve and blood vessel damage caused by high blood glucose levels.
Learn more in the Everyday Health Type 2 Diabetes Center.
I have neuropathy in my feet. It can be extremely painful at night, and it keeps me awake most nights. Is there any way to reduce the pain, and will this ever subside?
— Debbie, Wichita, KS
A:
Neuropathy is a painful and distressing complication of diabetes. In some people, it disappears on its own over a period of about 12 months. In others, however, it persists. There are medicines your doctor can prescribe to relieve your symptoms.
The U.S. Food and Drug Administration has approved two drugs, duloxetine and pregabalin, to treat the foot pain from diabetic neuropathy. Duloxetin is an antidepressant, and pregabalin is used to treat seizure disorders. Both have some side effects. Duloxetin can cause nausea, sleepiness, dizziness, decreased appetite, hot flashes, and constipation. Pregabalin can cause sleepiness and confusion and can also lead to dependence.
You might consider other kinds of treatment too, both traditional and not. In one Australian study, the antioxidant alpha-lipoic acid was shown to reduce pain. And other medications — including some antiseizure medications, antidepressants, and opiates — have been used with some success. Some people have used acupuncture, topical creams containing capsaicin (a substance found naturally in hot peppers), and other alternative therapies. Of course, many of these treatments have not been well studied enough to determine their effectiveness.
I would advise you to consult with your doctor to decide which treatment works best for you. It's important to remember, of course, that none of these medicines cure the underlying cause of neuropathy. That's why it's important to focus on tight glucose management. The basic problem that leads to neuropathy is nerve and blood vessel damage caused by high blood glucose levels.
Learn more in the Everyday Health Type 2 Diabetes Center.
Saturday, December 4, 2010
How Type 2 Diabetes Affects Relationships
Whether you're dating, married, or in a long-term relationship, a diagnosis of type 2 diabetes will affect both you and your partner.
Medically reviewed by Lindsey Marcellin, MD, MPH Print Email Having type 2 diabetes changes your life and can certainly affect relationships, whether you’re dating or married. Diabetes management requires a lot of your attention and focus, which may be hard for a partner unfamiliar with the disease to understand. You have to carefully monitor what you eat and check your blood sugar frequently throughout the day.
If you get sick and need help, your diabetes care may fall to your partner, who needs to learn about the disease to better assist you. If your partner is the one managing type 2 diabetes, you’ll want to get that education for yourself.
Diabetes: The Physical and Emotional Impact
People diagnosed with type 2 diabetes experience a wide range of emotions, including:
Fear
Anger
Depression
Denial
Guilt
Not only is the emotional aspect of diabetes a real rollercoaster, but there is also a physical impact on sexual function. The emotional strain of dealing with diabetes can cause stress and anxiety, as well as communication difficulties that can lead to sexual dysfunction in relationships.
Diabetes: Dating With Diabetes
There's more content below this advertisement. Jump to the content.
Ronda Keys, 37, an event planner from Maryland, was first diagnosed with type 2 diabetes at age 18, when she was in a serious relationship. She didn't know anyone else her age with the disease, so she tried to downplay its seriousness to her friends, her boyfriend, and even herself.
Keys, who is single, didn't want her boyfriend or friends to feel that they had to stop what they were doing or make accommodations for her diabetes, so she just didn't tell many people.
"I had to try to figure out how to still live a normal life and do normal things and manage my situation. After a while it just got to the point where I had to let people know," says Keys.
At first, her boyfriend just didn't know what he needed to do for her, what she needed from him, or anything about diabetes. "When you mention that you have diabetes, everyone wants to be the food police,” says Keys. She explained to him that she was still a normal, healthy person who just needed to make a few lifestyle adjustments to manage her disease.
Diabetes: Maintaining Bonds
Whether one or both partners have diabetes, there are things you can do to remain open and loving and strengthen your emotional bond, which in turn will help you navigate the changes that diabetes requires.
Here are coping techniques to ease you both through a diabetes diagnosis and for years afterwards:
Talk to each other. Adjusting to life with diabetes is difficult for patient and partner. Talk about what you're afraid of, what you're angry about, and what you need from your partner — and be sure to answer your partner's questions.Join a support group. Joining a support group for people with diabetes or family members of people with diabetes can be a valuable resource for both partners in a relationship. There you can talk to others experiencing the same challenges you are and exchange ideas on how to cope.Find ways to relieve stress. Dealing with diabetes can add a complex level of stress to a marriage, so find time to relax. Choose an activity or hobby that you each enjoy, together or alone, and regularly make time to forget about your troubles and have a little fun.Attend a diabetes education class together. This helped Keys and her boyfriend better understand her type 2 diabetes and adjust to her new reality. He learned about what she was facing and what she — and he — needed to do to manage her diabetes.Commit to lifestyle changes together. Keys says this was another important step in adjusting their relationship to accommodate her need for a healthier lifestyle. Her boyfriend altered his lifestyle as well to make it easier for her to stick with her improved habits. For people with type 2 diabetes struggling in their marriage or relationship, Keys stresses educating your partner and talking openly about your needs. Understand that your partner wants to help and often just needs you to show him or her the way
Medically reviewed by Lindsey Marcellin, MD, MPH Print Email Having type 2 diabetes changes your life and can certainly affect relationships, whether you’re dating or married. Diabetes management requires a lot of your attention and focus, which may be hard for a partner unfamiliar with the disease to understand. You have to carefully monitor what you eat and check your blood sugar frequently throughout the day.
If you get sick and need help, your diabetes care may fall to your partner, who needs to learn about the disease to better assist you. If your partner is the one managing type 2 diabetes, you’ll want to get that education for yourself.
Diabetes: The Physical and Emotional Impact
People diagnosed with type 2 diabetes experience a wide range of emotions, including:
Fear
Anger
Depression
Denial
Guilt
Not only is the emotional aspect of diabetes a real rollercoaster, but there is also a physical impact on sexual function. The emotional strain of dealing with diabetes can cause stress and anxiety, as well as communication difficulties that can lead to sexual dysfunction in relationships.
Diabetes: Dating With Diabetes
There's more content below this advertisement. Jump to the content.
Ronda Keys, 37, an event planner from Maryland, was first diagnosed with type 2 diabetes at age 18, when she was in a serious relationship. She didn't know anyone else her age with the disease, so she tried to downplay its seriousness to her friends, her boyfriend, and even herself.
Keys, who is single, didn't want her boyfriend or friends to feel that they had to stop what they were doing or make accommodations for her diabetes, so she just didn't tell many people.
"I had to try to figure out how to still live a normal life and do normal things and manage my situation. After a while it just got to the point where I had to let people know," says Keys.
At first, her boyfriend just didn't know what he needed to do for her, what she needed from him, or anything about diabetes. "When you mention that you have diabetes, everyone wants to be the food police,” says Keys. She explained to him that she was still a normal, healthy person who just needed to make a few lifestyle adjustments to manage her disease.
Diabetes: Maintaining Bonds
Whether one or both partners have diabetes, there are things you can do to remain open and loving and strengthen your emotional bond, which in turn will help you navigate the changes that diabetes requires.
Here are coping techniques to ease you both through a diabetes diagnosis and for years afterwards:
Talk to each other. Adjusting to life with diabetes is difficult for patient and partner. Talk about what you're afraid of, what you're angry about, and what you need from your partner — and be sure to answer your partner's questions.Join a support group. Joining a support group for people with diabetes or family members of people with diabetes can be a valuable resource for both partners in a relationship. There you can talk to others experiencing the same challenges you are and exchange ideas on how to cope.Find ways to relieve stress. Dealing with diabetes can add a complex level of stress to a marriage, so find time to relax. Choose an activity or hobby that you each enjoy, together or alone, and regularly make time to forget about your troubles and have a little fun.Attend a diabetes education class together. This helped Keys and her boyfriend better understand her type 2 diabetes and adjust to her new reality. He learned about what she was facing and what she — and he — needed to do to manage her diabetes.Commit to lifestyle changes together. Keys says this was another important step in adjusting their relationship to accommodate her need for a healthier lifestyle. Her boyfriend altered his lifestyle as well to make it easier for her to stick with her improved habits. For people with type 2 diabetes struggling in their marriage or relationship, Keys stresses educating your partner and talking openly about your needs. Understand that your partner wants to help and often just needs you to show him or her the way
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