NEW YORK (Reuters Health) - Diabetic individuals who have happy marriages are more likely to be satisfied with their diabetes-related quality of life than their unhappily married peers, new study findings suggest. They are also less likely to experience emotional distress because of their diabetes, researchers report.

"Being in a satisfying and intimate marital relationship predicts that you will experience a better quality of life and especially a better adaptation to the diabetes," Dr. Paula M. Trief of the State University of New York Upstate Medical University in Syracuse told Reuters Health.

Trief and her colleagues surveyed 78 adults with diabetes who had been married for an average of 21 years. Follow-up interviews were performed approximately 2 years after the initial survey.

Overall, the patients' initial reports about their marital adjustment and intimacy, respectively, predicted both their levels of diabetes-related emotional distress and their satisfaction with their diabetes-related quality of life at follow-up, the investigators report in the July issue of Diabetes Care.

For example, patients who initially reported high levels of intimacy in their marriage were more likely to report increased satisfaction with their diabetes regimen 2 years later, even after the researchers took into account their education level and diabetes-related quality of life.

Similarly, patients who initially reported better marital adjustment also reported greater satisfaction with their diabetes regimen at follow-up.

"When people are in a good marriage, their partner is more likely to support their efforts to take care of their diabetes," Trief said. "It may also be that people who know how to work at establishing and maintaining a good marriage are the people who know how to work hard at managing and coping with diabetes."

However, the study participants' marital quality and intimacy was not found to be associated with their overall health-related quality of life, the authors note.

"It may mean that marital domains are especially relevant to issues specific to the disease of diabetes," Trief and her team speculate. "However, it may be that overall health-related quality of life is more stable than diabetes-specific quality of life."

In light of the findings, "healthcare workers should pay attention to the social and relationship context of their patients," Trief said. "And, if relationship problems exist, (they should) recognize that this may translate into a poorer adaptation to the diabetes and might require a referral for professional marital counseling," she suggested.

"Both the marriage and the diabetes affect each other and need attention," she added. "As diabetes is a demanding disease, the person with diabetes needs all the help they can get in managing it."

SOURCE: Diabetes Care 2002;25:1154-1158.

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