How to Help Your Spouse Manage Diabetes 8 Fight-Free Tips for Encouraging Lifestyle Changes

Has your husband been diagnosed with type 2 diabetes? How do you help your hubby stay healthy without a fight? Our experts offer 8 fight-free tips to help him make lasting lifestyle changes, without causing stress in your marriage... Mitch Chester, 63, is an auto-parts store manager who snacks on potato chips, eats burgers for lunch and loves to watch sports on TV. Not surprisingly, he was recently diagnosed with type 2 diabetes. His wife, Susan, 59, avoids junk food and takes three Jazzercise classes a week. She was frightened when the doctor revealed Mitch’s condition. “I walked out of there thinking I was about to become a widow,” Susan recalls. A drug was prescribed to help control Mitch’s blood sugar. The doctor also told him to lose weight and exercise more to prevent life-threatening complications like heart disease and kidney damage. As they drove away, Susan suggested stopping for lunch at a salad place near a park where they could walk. Mitch said he wanted a bacon cheeseburger. “I told him to do what the doctor said,” Susan says. “He said, ‘Don’t nag me.’” That was the first of many such arguments. If this sounds familiar, know that it is possible to influence your man’s health choices without mothering (or smothering) him. The key, experts say, is to identify what really motivates him – and offer encouragement to help him make gradual, but lasting, lifestyle changes. Follow these 8 tips from diabetes professionals. 1. Be positive. “Nagging never works,” says family practitioner Anne Simons, M.D., an associate professor of family and community medicine at the University of California-San Francisco Medical Center who has dozens of diabetic patients. “Unfortunately, that’s what spouses often do,” she adds. As with the Chesters, a loved one is often more concerned with learning how to manage diabetes than the person who has it. Perhaps that's because diabetes doesn’t cause discomfort until it’s fairly advanced. “Family members perceived diabetes to be more serious than those with the disease,” concluded a 2007 study at Trinity College in Dublin, in which researchers surveyed relatives of patients at a diabetes clinic. They found that relatives were more likely to see diabetes as a chronic illness that requires ongoing treatment. Nonetheless, spousal encouragement plays a major role in persuading diabetics to make lifestyle changes. At the South Texas Veterans Health Care System in San Antonio, researchers surveyed 138 diabetics about their social support and commitment to a healthy diet and regular exercise. The more support they had, the healthier lifestyle changes they made. And in a 2010 study at Kent State University in Ohio, researchers interviewed 109 spouses of diabetics about the kind of persuasion they attempted – either positive encouragement (“How about non-fat yogurt on your baked potato instead of butter?”) or negative warnings (“If you don’t lose weight, you’ll go blind!”). Patients who received encouragement were more likely to adopt dietary recommendations. “The message shouldn’t be, ‘We have to change you,’” Simons says. “It should be, ‘I love you and I’ll do whatever I can to support you. What are you willing to do?’” 2. Find the right motivations. When Mitch was first diagnosed, Susan cleared the house of everything she thought might contribute to his condition: chips, ice cream, pasta, frozen pizza. He roared that there was nothing left to eat. “I see this all the time,” says Sacha Uelmen, R.D., C.D.E., director of the Adult Diabetes Education Program at the University of Michigan. “The wife assumes the worst and overhauls the kitchen, which makes the husband angry and resentful.” So instead of forcing lifestyle changes, encourage him to decide what’s really important to him. “It’s about his motivation to change, not hers,” Simons says. “Maybe he wants to look better in a bathing suit, or feel more energetic or be able to play more with his children or grandchildren. Maybe he really values providing for his family and doesn’t want to wind up disabled.” Then find ways to manage diabetes that you can participate in as a couple, suggests nurse practitioner RaShaye Freeman, CDE, who counsels diabetics and their families for the Veterans Administration in Los Angeles. “Offer to attend diabetes-education classes with him,” she says. “Take walks together, or get involved in other exercises he likes.” 3. Start with small changes. When a man is diagnosed with type 2 diabetes, his loved ones may become impatient and insist he overhaul his entire lifestyle right away. “The problem is that big changes are like crash diets,” Uelmen says. “They don’t last.” “Men don’t like to be treated like children,” Simons adds. “Suggest small changes and involve him in making decisions. Give him choices and options.” Aim for small, gradual adjustments that move him in a healthier direction. “If he drinks whole milk, don’t suddenly change to fat-free – it’ll taste too watery,” Uelmen says. “Move to 2%, then maybe six months later, try 1%.” When asking him to make changes, “be specific,” Freeman says. “Instead of pledging he’ll cut down on sweets, it’s better for him to commit to switching from regular soda to diet.” 4. Don’t eliminate all his favorite foods. Many patients are overweight or even obese, and need to lose weight in order to manage diabetes. But what’s the best way to do it? Simons tells her diabetic patients: “Cut down on meats, especially the fatty ones, and whole-milk dairy foods to promote weight loss. And cut down on refined carbs to control blood sugar – eat vegetables and whole grains instead.” Refined carbs include white flour, sugar, white pasta and white rice. “My mantra is moderation, not elimination,” Uelmen says. If he loves ice cream, he can have it – occasionally, in small portions.” Some diabetes authorities tout menu planning based on the glycemic index (GI), which measures how much a carbohydrate-containing food raises blood sugar. The higher a food’s GI, the more impact it has on blood sugar levels. And in general, the more processed a food is, the higher its GI. White bread, for instance, has a higher GI than whole-grain bread. However, other experts find the GI system too complicated as a method for weight loss. “I stress cutting down on fats, particularly saturated fats in meat and cheese, limiting portion size, and exercise,” Freeman says. 5. Consider convenience. A great deal of unhealthy eating is mindless, nutritionists say. If your guy wants a snack and there are cookies sitting out, he’s likely to eat them. So you can help him manage diabetes by keeping healthful foods easy to reach, and unhealthy snacks out of the way, Uelmen suggests. “Keep a fruit bowl on the kitchen counter,” she recommends. “My husband likes fruit – and if it’s right in front of him, he’ll eat it.” 6. Don’t forget flavor. Increasing vegetable consumption can be an important factor is promoting weight loss. Non-starchy veggies are packed with nutrients yet very low in calories and carbohydrates, according to the American Diabetes Association. With all that going for them, you’d think people would be more willing to eat their vegetables. “The problem is that many Americans grew up eating horribly overcooked vegetables that taste like mush,” Uelmen explains. If you’re the main family chef, you can help by learning the most flavorful cooking techniques. Uelmen suggests serving lightly steamed vegetables topped with a little salad dressing. “They keep their crunch,” Uelmen says. “I also roast vegetables with a little olive oil,” she says. 7. Help make exercise enjoyable. The most important element of exercise is fun, Uelmen notes. “Any physical activity helps – he doesn’t have to join a gym,” she says. “If he enjoys Ping-Pong, that can get him moving. If he likes to bowl, have couples’ bowling nights. If he likes golf, encourage him to walk part way instead of always riding a cart.” He’s more likely to stay active if you join in, adds Freeman. “Offer to take walks together, or get involved in other exercise he likes,” she suggests. 8. Get help. Your guy may take advice on how to manage diabetes more seriously if it comes from a professional – such as a clinical nutritionist or certified diabetes educator. “If you’re having trouble getting through to him, ask if he’d like to consult an expert – then go to the appointment together,” Uelmen suggests. “Let the expert explain things.” Afterward, ask, “What are you willing to do to stay healthy?” When Susan Chester started asking that question, Mitch admitted that he really did want to lose weight and didn’t want to develop diabetes complications. After that, he stopped grabbing fast-food breakfast sandwiches and now eats cereal with low-fat milk and fruit at home in the morning. He still snacks on chips, but buys smaller bags. And he still watches lots of sports on TV, but often while walking on the new treadmill in the den. So far, he has lost 12 pounds. “It’s a start,” Susan says. “He feels more energetic and likes it. Best of all, we’re bickering less.” She adds, “I would do things differently, but it’s not about me – it’s about Mitch and how he wants to change.” Library Journal named Michael Castleman “one of the nation’s top health writers.” He co-authored Building Bone Vitality (McGraw-Hill) with Amy Joy Lanou, Ph.D. For more on preventing, recognizing and managing diabetes, visit our Diabetes Health Center. Myth vs. Facts: How Much Do You Know About Diabetes? In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about diabetes is rampant – and mixing up the facts about this disease can have dire consequences.