New Diabetes Diagnosis Could Benefit Household

FPs Can Leverage 'Teachable Moment,' Says Researcher

July 13, 2018, 03:12 pm Chris Crawford – Partners of patients who have been recently diagnosed with diabetes are more likely to improve their health behaviors than are partners of patients without the disease. That's the primary finding of a study published in the July/August issue of Annals of Family Medicine.

In a study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, researchers based their conclusion on a review of the electronic health records of more than 180,000 co-residing couples who were members of Kaiser Permanente Northern California from 2007-2011. The researchers matched each patient newly diagnosed with diabetes and their co-residing partner with five matched patients without diabetes and their co-residing partners and assessed changes in eight health behaviors for a year pre- and postdiagnosis.

Partners of patients with diabetes included in the study had a mean age of 54.3 and a mean body mass index (BMI) of 29.4 kg/m2; 62.8 percent were female and 53.2 percent were white. The control group of partners of patients without diabetes had a mean age of 53.2 years and a mean BMI of 27.8 kg/m2; 65.4 percent were female and 53.2 percent were white.

physician speaking with older man and his wife

The diabetes diagnosis date for each first partner was used as the index date for that couple. The index date for members of the comparison group was Jan. 1 of the year of their match's diabetes diagnosis.

Partner behaviors examined were fasting plasma glucose or glycated hemoglobin A1c testing, lipid level testing, blood pressure testing, influenza vaccination, use of a smoking cessation medication, tobacco-use status, participation in a weight-related health education class, and meaningful weight loss (defined as at least 5 percent of baseline weight) after the index date.

The researchers found that partners of patients with type 2 diabetes were about twice as likely to take a weight management class and 25 percent more likely to use a smoking cessation medication, compared to partners of people without type 2 diabetes.

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Participation among partners of patients with diabetes in other health behaviors -- glucose screening, clinically meaningful weight loss, lipid screening, influenza vaccination and blood pressure screening -- was between 2 percent and 7 percent higher than among partners of patients without diabetes.

"When a patient develops diabetes, their doctors and other health care professionals will most likely provide information on how to reduce the risk of diabetes complications through improved nutrition and exercise," the study's lead author Julie Schmittdiel, Ph.D., research scientist with the Kaiser Permanente Division of Research, Oakland, Calif., told AAFP News. "This information on healthy lifestyles brought into the household may help and inspire others within the family to make changes, as well."

Schmittdiel's co-authors were Sara Adams, M.P.H., also with the Kaiser Permanente Division of Research; Solveig Cunningham, Ph.D., M.Sc., associate professor in the Hubert Department of Global Health, Emory University; Mohammed Ali, M.B.Ch.B., M.Sc., M.B.A., associate professor of global health and epidemiology in the Rollins School of Public Health at Emory; and Jannie Nielsen, Ph.D., a visiting assistant professor at Emory Global Diabetes Research Center.

"Family physicians who want to address health at the household level may be able to use a person's diabetes diagnosis as an opportunity and 'teachable moment' to provide counseling and information to the entire family," Schmittdiel said.

These findings of residual improved health behaviors for partners of patents with diabetes are interesting because some research has suggested that spouses and partners of patients with diabetes may have an elevated risk of developing the disease themselves due to shared health behaviors such as dietary and exercise habits.

"Dietary patterns and exercise levels can be associated with diabetes risk," Schmittdiel said. "Since people within households may share meals and other lifestyle habits, risk for diabetes may be correlated among people who live together."

Although previous studies have shown that lifestyle interventions can reduce diabetes risk, it remains unclear whether exposure to guidance and education regarding healthy behaviors geared toward patients with diabetes may also result in behavior changes in people living with those patients.

The authors concluded that this study showed the partners of patients with diabetes make more positive changes in health care-seeking and health behaviors compared with partners of patients without diabetes.

"Future research should harness this teachable moment and identify interventions that can effectively reduce overall health risks in both partners," the study authors advised.

"More research that focuses on interventions designed to improve family health may help reduce family and household-level disease risk," Schmittdiel concluded.

Familydoctor.org: Diabetes