The Value of Relationships in Diabetes
Relationships play a significant role in our lives. We experience relationships on many levels: With ourselves, with others, with our environment and through our spiritual connection. Have you ever noticed when you are in sync with the universe, everything goes smoothly? You feel good, you look great, and you are at peace. The reality is that not very many of us experience a smooth ride. We may not like how we look and may beat ourselves up for gaining that extra 15 pounds. We might be fighting with our spouse, working in a strife filled environment, or blaming god and the universe for a loved one’s passing. The turmoil in our relationships; with ourselves, others, our environment and our beliefs can either make us sick, or healthy. In addition, our perception of our collective experiences is the determining factor on whether something will make you ill or well: “We are the architects of our own experience”. (Dobs 2013)
This paper will look at two studies examining one positive aspect of the relationship dimensions and one potentially problematic relationship, in patients with type 2 diabetes (T2D).
The first study aimed to identify the spiritual health of patients with defects caused by diabetes to determine the value of the spiritual relationship in overall health and healing. (Salehi et al, 2012) Amputation due to diabetes can cause a crisis in the physical, mental, and spiritual life of the individual. In this case, the spiritual health is the unique element that can harmonize physical, mental and social aspects of the human life and is necessary for coping with the disease. (Fernsler et al., 1999) As a matter of fact, when the spiritual health is seriously at risk, a person may experience emotional disturbances such as loneliness, depression and loss of meaning in life.
The findings of this study revealed that religious sources and having a strong relationship with a higher power could improve the quality of life, supporting the individuals and reducing the severity of their symptoms. (Salehi et al., 2012)
The revelation that came from this study is twofold. It showed that spiritualty and a belief in a higher power contributed to the acceptance of the loss of a limb in conjunction with advanced diabetes. However, it was the individual participants perception (a way of regarding, understanding, or interpreting something; a mental impression) of their spiritual connection that predicted whether the outcome would be positive or negative.
“The concepts derived from patients’ experiences as factors interfering with spiritual health in the treatment process were: disappointment, hopelessness, guilt, feeling distant from God, quitting obligatory acts and considering God cruel. Factors promoting the healing process were that it was deemed by God, belief in miracles, being closer to God, believing God to be merciful, returning to religious practice, enjoying life and indicating the disease as the atonement of sins.” (Salehi et al., 2012) Several of the participants believed their connection to God was significant in their acceptance and peace surrounding their circumstance, where others blamed God and so were living an unhappy reality. It would have been beneficial if the study had continued for 2 to 3 years, to provide an indication of the participants health status after living with positive or negative feelings towards their spirituality for a period of time.
A second peer-reviewed article that interested me was a large study done in the Netherlands in 2017 (2861 participants aged 52 to 68 +/-, 49% female, 51% male) which looked at the associations of a broad range of structural and functional social network characteristics with normal glucose metabolism, pre-diabetes, newly diagnosed type 2 diabetes and previously diagnosed type 2 diabetes. (Brinkhues et al., 2017)
The results in fact showed some significant findings: (Brinkhues et al., 2017)
People who had social networks of 10 to 12 people were less likely to develop type 2 diabetes than people with only seven to eight close friends. Each drop in the number of friends was linked to a 5 percent to 12 percent higher risk.
One unit less emotional support on important decisions was associated with 34% higher odds of newly diagnosed T2D in women, while it was 19% respectively for men.
Men living alone were more likely to get type 2 diabetes, while living alone didn't seem to affect a woman's risk of having the disease.
A lack of social participation was associated with 60% higher odds of pre-diabetes and 112% higher odds of previously diagnosed T2D in women.
While the above is only some of the statistics that came out of the study, they begin to paint a very clear picture of the importance of social support to a chronic illness such as diabetes. The fact that several environmental and lifestyle factors, as well as psychosocial factors such as depression and stress, have been identified as relevant for the development of T2D, shows the need for healthy relationships with others. (Brinkhues et al., 2017)
In both studies, scales that measure the relationships provided both qualitative and quantitative data. The first study, highlighting the importance of spirituality in dealing with disease, revealed the significance of one’s perception on the relationship with their higher power. I believe this is because the relationship, in this case, was with God and it is for all intense purposes, a one-way relationship. For some, whose faith may be wavering and the connection not strong enough to serve them in a positive way, it was less beneficial and may have actually become a detriment. Considering the findings of the second study, the relationships examined were of a close and personal nature, providing two-way communication and interaction. Perhaps the ability to physically connect and interact is an important component for those with diabetes.
References:
Dobbs, D. (2013) Feature Story: The Social Life of Genes. Pacific Standard Magazine. Retrieved from https://psmag.com/social-justice/the-social-life-of-genes-64616
Salehi, S., Ghodousi, A., & Ojaghloo, K. (2012) The spiritual experiences of patients with diabetes- related limb amputation. Iranian Journal of Nursing and Midwifery Research.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696216/
Fernsler JI, Klemm P, Miller MA. (1999) Spiritual well-being and demands of illness in people with colorectal cancer. Cancer Nurs. 22(3):134–40. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10217029
O’Brian ME. (1998) Spirituality in nursing: standing on holy ground. Jones and Bartlett Learning. Retrieved from http://samples.jbpub.com/9781449694678/9781449694678_CH01_Pass1.pdf
Brinkhues, S., Dukers-Muijrers, N., Hoebe, C., Van der Kallen, C., Dagnelie, P., Koster, A., Henry, R.M.A., Sep, S., Schaper, N.C., Stehouwer, C., Bosma, H., Savelkoul, P., & Schram, M.T. (2017) Socially isolated individuals are more prone to have newly diagnosed and prevalent type 2 diabetes mellitus - the Maastricht study. BMC Public Health.
Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4948-6