Background: The importance of spousal support in type 2 diabetes mellitus (T2DM) patient management is often neglected. We prospectively investigated spouses' needs for T2DM information, and whether their perceptions of health changes in their diabetic partners correlated with changes in objective and subjective health parameters for the partners. Methods: Spouses and partners with T2DM (n=52 per group) were followed for two years. Questionnaires on T2DM information/education and general health perception of themselves and their partners were given to spouses at start and end of study. Perceived changes in partners' health were compared with changes in objective (10-year Framingham coronary heart disease risk) and subjective (health-related quality-of-life [EuroQoL]) measures. Results: Spouses' (mean age±SD 58±10 years, n=42 females) self-reported needs for T2DM information/education were high at both assessments (61.5%/76.7%; 46.2%/63.0%, respectively). General health of diabetic partners (mean age 60±8 years, n=42 males) was perceived as improved by 10%, worsened by 27% and unchanged by 63% of spouses. Significant correlations were observed between spouses who perceived improvements in partners' health, and subjective and objective parameters of partners' health (EuroQoL scores increased by 18; Framingham risk reduced by 2.0±3.0%); similar correlations were observed in spouses who perceived worsening of partners' health (EuroQoL scores decreased by 7±15; Framingham risk increased by 1.7±4.1%). Spouses' results showed moderate sensitivity for capturing health worsening in relation to increase in Framingham risk (57%); specificity in relation to no change or reduction in Framingham risk was high (74%). Conclusion: Spouses' needs for T2DM information/education were high. Perceived changes in partners' health significantly correlated with subjective and objective outcome data. Further studies should investigate whether spouses' perceptions of negative changes could be used to trigger more intensive T2DM management strategies.

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Chronic hyperglycaemia (e.g. type 2 diabetes mellitus (T2DM) and prediabetes) in humans is associated with an increased risk of cardiovascular (CV) complications, and, vice versa, the presence of CV complications (e.g. myocardial infarction, stroke or intermittent claudication) among patients heightens the risk of T2DM or prediabetes. In both cases (i.e. chronic hyperglycaemia and CV complications), significant diagnostic and treatment challenges resulting from a broad range of factors may serve as barriers to reducing the deleterious societal impact of T2DM and prediabetes. These challenges often include clinicians: failing to intervene early and aggressively enough among patients with T2DM to achieve CV risk factor control; failing to efficaciously identify T2DM patients with already established CV complications; and failing proactively to assess individuals at high risk for T2DM. This review discusses the apparent symbiosis between CV disease and T2DM, with a focus on identifying patients with established T2DM or at risk for T2DM; traditional and novel risk factors and markers for CV disease in T2DM; challenges related to diagnosing CV disease in T2DM; and organization of T2DM care in order to prevent CV complications. These are issues that require attention because identifying patients at high risk for T2DM can halt or reduce their further glycaemic deterioration if addressed properly, and because novel markers and non-invasive tests could be applied in patients with T2DM as a means of detecting and possibly treating unrecognized CV disease in time. Furthermore, several approaches for T2DM care can be effective in controlling the CV risk factors contributing to CV complications.

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Background: Type 2 diabetes mellitus is a chronic disease that may have a severe impact on the quality of life of patients themselves and their families. For patients living in a partnership, the involvement of and relations with spouses might be of importance. Aims: This study aims to investigate self-assessed health-related quality of life (HRQL) in spouses and people with type 2 diabetes and describe spouses' need for knowledge about type 2 diabetes. Methods: Caucasian (n=75) people with type 2 diabetes (age 60±9 years, female/male16/59, HbA 1c 7.5±1.6%) and their spouses (age 59±11 years, living in heterosexual relationship) performed self-assessment using SF-36 Norwegian version 1.2. Spouses were also asked about their need for education and information about type 2 diabetes. Results: Three SF-36 health dimensions (general health perceptions, mental health, social functioning) were significantly reduced among people with type 2 diabetes, as compared to spouses and normative data (p<0.001), while the spouses' HRQL was similar to the normative data. The majority (57%) of spouses wanted more information about the disease. Only a minority (31%) of the spouses felt supported in the provision of diabetes information by the healthcare providers system and few had received information from professionals (23%). Conclusions: People with type 2 diabetes have reduced HRQL as compared with their spouses; but living in such a partnership does not reduce the SF-36 scores of the spouses, compared with the general population. As the majority of spouses wanted more information about type 2 diabetes and did not feel supported by the healthcare system, strategies that aim to improve their educational levels might be helpful for the treatment of people with type 2 diabetes living in a partnership.