The Experience of Partners of Adults with Type 1 Diabetes: an Integrative Review

Purpose of ReviewThe purpose of this review was to synthesize the research on the experience of partners living with adults with type 1 diabetes (T1D).Recent FindingsEleven studies were included in the review. Three themes on the experience of living with a person with T1D were identified: the undercurrent of hypoglycemia, partners’ involvement in diabetes care, and the impact on partners’ lives. Due to considerable fear of hypoglycemia, partners had pervasive and deliberate ways in which they made attempts to minimize hypoglycemia in the person with diabetes and its cascade to a health emergency. As a result, partners of adults with T1D experienced considerable distress and disrupted lives. Partners also expressed a need for more support from family, friends, and health professionals.SummaryResearch is needed on the partner experience across the lifespan and the specific supportive services they need in order to optimize their health outcomes.

[1]  K. Nadeau,et al.  Cardiovascular Disease Risk in Young People with Type 1 Diabetes , 2012, Journal of Cardiovascular Translational Research.

[2]  N. Chaytor Cognition in Adults and Older Adults With Type 1 Diabetes: Chicken or Egg? , 2016, Diabetes Spectrum.

[3]  Bruce W Bode,et al.  AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2016 OUTPATIENT GLUCOSE MONITORING CONSENSUS STATEMENT. , 2016, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[4]  W. Polonsky,et al.  Emotional Distress in the Partners of Type 1 Diabetes Adults: Worries About Hypoglycemia and Other Key Concerns. , 2016, Diabetes technology & therapeutics.

[5]  W. Tamborlane,et al.  Constant vigilance: mothers' work parenting young children with type 1 diabetes. , 2003, Journal of pediatric nursing.

[6]  J. Lisspers,et al.  Fear of hypoglycaemia in adults with Type 1 diabetes , 2010, Diabetic medicine : a journal of the British Diabetic Association.

[7]  David M Maahs,et al.  Current State of Type 1 Diabetes Treatment in the U.S.: Updated Data From the T1D Exchange Clinic Registry , 2015, Diabetes Care.

[8]  I. Willaing,et al.  Type 1 diabetes and living without a partner: psychological and social aspects, self-management behaviour, and glycaemic control. , 2013, Diabetes research and clinical practice.

[9]  C. Himes,et al.  The marital relationship and psychosocial adaptation and glycemic control of individuals with diabetes. , 2001, Diabetes care.

[10]  R. Beck,et al.  Risk Factors Associated With Severe Hypoglycemia in Older Adults With Type 1 Diabetes , 2015, Diabetes Care.

[11]  K. Borch-Johnsen,et al.  The impact of severe hypoglycemia and impaired awareness of hypoglycemia on relatives of patients with type 1 diabetes. , 2003, Diabetes care.

[12]  R. Weinstock,et al.  A prospective analysis of marital relationship factors and quality of life in diabetes. , 2002, Diabetes care.

[13]  I. Willaing,et al.  Associations between patient characteristics, social relations, diabetes management, quality of life, glycaemic control and emotional burden in type 1 diabetes. , 2016, Primary care diabetes.

[14]  S. Kelsey,et al.  Cause-Specific Mortality Trends in a Large Population-Based Cohort With Long-Standing Childhood-Onset Type 1 Diabetes , 2010, Diabetes.

[15]  12. Management of Diabetes in Pregnancy , 2014, Diabetes Care.

[16]  R. Sherwin,et al.  Hypoglycemia in Type 1 Diabetes , 2010, Diabetes.

[17]  B. Anderson Diabetes self-care: Lessons from research on the family and broader contexts , 2003, Current diabetes reports.

[18]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement , 2009, BMJ.

[19]  R. Whittemore,et al.  Psychological Experience of Parents of Children With Type 1 Diabetes , 2012, The Diabetes educator.

[20]  S. Penckofer,et al.  Fear of hypoglycemia: Influence on glycemic variability and self-management behavior in young adults with type 1 diabetes. , 2017, Journal of diabetes and its complications.

[21]  Jorie M. Butler,et al.  Longitudinal trajectories of parental involvement in Type 1 diabetes and adolescents' adherence. , 2014, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[22]  R. Brugha,et al.  Why do young adults with Type 1 diabetes find it difficult to manage diabetes in the workplace? , 2014, Health & place.

[23]  Zhu Jialiang,et al.  Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression , 2022, Frontiers in Endocrinology.

[24]  R. Beck,et al.  Hypoglycemia in Older Adults with Type 1 Diabetes. , 2016, Diabetes technology & therapeutics.

[25]  H. Turunen,et al.  Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. , 2013, Nursing & health sciences.

[26]  S. Wild,et al.  Estimated life expectancy in a Scottish cohort with type 1 diabetes, 2008-2010. , 2015, JAMA.

[27]  R. Beck,et al.  Sustained Benefit of Continuous Glucose Monitoring on A1C, Glucose Profiles, and Hypoglycemia in Adults With Type 1 Diabetes , 2009, Diabetes Care.

[28]  C. Uk Critical appraisal skills programme (CASP): checklists. , 2013 .

[29]  H. B. Nielsen,et al.  Type 1 diabetes, quality of life, occupational status and education level - A comparative population-based study. , 2016, Diabetes research and clinical practice.

[30]  P. Åstedt‐Kurki,et al.  Interrelation Between Adult Persons With Diabetes and Their Family , 2013, Journal of family nursing.

[31]  L. Strycker,et al.  Diabetes distress in adults with type 1 diabetes: Prevalence, incidence and change over time. , 2016, Journal of diabetes and its complications.

[32]  T. Kamarck,et al.  Daily Marital Interaction Quality and Carotid Artery Intima-Medial Thickness in Healthy Middle-Aged Adults , 2014, Psychosomatic medicine.

[33]  F. Pouwer,et al.  Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association , 2018 .

[34]  Transl. D.D. Ivanov,et al.  American Diabetes Association. Standards of Medical Care in Diabetes — 2017 , 2017 .

[35]  R. Whittemore,et al.  The integrative review: updated methodology. , 2005, Journal of advanced nursing.

[36]  J. T. ter Maaten,et al.  Improving self‐management in insulin‐treated adults participating in diabetes education. The role of overprotection by the partner , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[37]  R. Brugha,et al.  What’s distressing about having type 1 diabetes? A qualitative study of young adults’ perspectives , 2013, BMC Endocrine Disorders.

[38]  J. Jull,et al.  Adult-Onset Type 1 Diabetes: A Qualitative Study of Decision-Making Needs. , 2016, Canadian journal of diabetes.

[39]  M. Fornage,et al.  Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association , 2017, Circulation.

[40]  R. Weinstock,et al.  Management of Type 1 Diabetes in Older Adults , 2014, Diabetes Spectrum.

[41]  R. Whittemore,et al.  Physical Activity in Adults With Type 1 Diabetes , 2016, The Diabetes educator.

[42]  David Kerr,et al.  Impact of Type 1 Diabetes Technology on Family Members/Significant Others of People With Diabetes , 2016, Journal of diabetes science and technology.

[43]  A. Folsom,et al.  Cardiovascular Risk Factor Targets and Cardiovascular Disease Event Risk in Diabetes: A Pooling Project of the Atherosclerosis Risk in Communities Study, Multi-Ethnic Study of Atherosclerosis, and Jackson Heart Study , 2016, Diabetes Care.

[44]  R. Sanderman,et al.  Support behavior and relationship satisfaction in couples dealing with diabetes: main and moderating effects. , 2010, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[45]  Sanjian Chen,et al.  Continuous Glucose Monitoring for Hypoglycemia Avoidance and Glucose Counterregulation in Long-Standing Type 1 Diabetes , 2018, The Journal of clinical endocrinology and metabolism.

[46]  Impact of continuous glucose monitoring on diabetes management and marital relationships of adults with Type 1 diabetes and their spouses: a qualitative study , 2014, Diabetic medicine : a journal of the British Diabetic Association.

[47]  Shireen S. Rajaram,et al.  Experience of hypoglycemia among insulin dependent diabetics and its impact on the family , 1997 .

[48]  D. Cox,et al.  The Psychosocial Impact of Severe Hypoglycemic Episodes on Spouses of Patients With IDDM , 1997, Diabetes Care.

[49]  R. Beck,et al.  Depression in Adults in the T1D Exchange Clinic Registry , 2014, Diabetes Care.

[50]  M. Fisher,et al.  Severe Hypoglycemia and the Role of the Significant Other , 2015, The Diabetes educator.

[51]  Tara K. Knight,et al.  Adults with type 1 diabetes: Partner relationships and outcomes , 2017, Journal of health psychology.

[52]  S. Heller,et al.  Experiences, Views, and Support Needs of Family Members of People With Hypoglycemia Unawareness: Interview Study , 2013, Diabetes Care.