The role of spousal support for dietary adherence among type 2 diabetes patients: a narrative review

Abstract

Healthy eating is key to successful management of type 2 diabetes (T2D). As discussed in this narrative review, there are strong indications that spousal support is an important element affecting dietary adherence in T2D. To provide a synthesized review of this evidence, Google Scholar and PubMed were searched, 28 relevant studies were selected, and the results were narratively summarized. A framework for information synthesis was developed which categorized results into three major themes: how gender roles and spousal dynamics function in spousal support for dietary adherence, the role of race and ethnicity in the influence of spousal support on dietary adherence, and the extant interventional work specifically targeting spousal support for T2D. The reviewed studies indicate that gender role performance is the principal factor in the relationship between spousal support and dietary adherence in T2D, though race and ethnicity also contribute. Despite this evidence, interventions that specifically target spousal support to improve dietary adherence in T2D have had limited efficacy. A better understanding of the relationship between spousal support and dietary adherence, as well as a subsequent utilization of this information to create targeted and effective interventions, would be of great benefit to the field of diabetes management.

A qualitative study of users’ experiences after 3 months: the first Rwandan diabetes self-management Smartphone application “Kir’App”

“…The involvement of family members and peers in diabetes self-management interventions has been found to be important in several current reviews. 36,37 Interactive forums and social media functions are nevertheless missing from the app, yet have proven effective in reducing HbA1c due to the support they can provide. 38 Users also appreciated having the app in both English and their mother tongue, which, as they say, allows them to better understand the information and therefore leads to more comfortable app use.…”

What should governments be doing to prevent diabetes throughout the life course?

“…Such interventions should be initiated early in pregnancy and continue throughout the pregnancy, as major short-and long-term health consequences for both the mother and the child are likely. • Develop and implement national diabetes plans as well as regional strategies promoting local partnerships with communities and stakeholders [38] • Governments should support the implementation of interdisciplinary care teams, with special regard to the involvement of pharmacists [39] • Improve the transparency of product ingredients using mandatory simple and intuitive nutrition or menu labelling [40] • Set up government food benefit programmes to incentivise the purchase of fruit and vegetables [41] • Support the certification of digital devices and apps to improve access to evidencebased health information [42] • Use narrative and visual messages to improve diabetes awareness [43] • Support interpretative nutrition labelling, like traffic lights, to decrease SSB sales [41] • Strengthen the framing of diabetes as a problem to be tackled on the societal level [44] • Raise taxes on unhealthy products (and consider the liability for adverse health effects of food and beverage products) and reinvest the money in local infrastructure (outdoor gyms and playgrounds) [45] Pregnant women and young families • Screen high-risk groups (elevated risk due to family history, increased BMI) for early detection of GDM [46] as a precondition for lifestyle change • Give advice regarding healthy eating and set activity targets during pregnancy [47,48] • Give advice regarding the benefits of breastfeeding [49] • Employ multimedia communication strategies to increase the widespread knowledge of diabetes risk during pregnancy [50,51] Children and adolescents…”

“…Informing family members living in the same household about possible complications such as hypoglycaemia can also improve emergency diabetes care [90,91]. Policy strategies to change diabetes-related and diabetes risk behaviour should therefore target not only the individual but also their direct social environment [45]. To enhance diabetes awareness both in the general population and in at-risk groups (e.g.…”

The burden of treatment in people living with type 2 diabetes: A qualitative study of patients and their primary care clinicians

“…The rigidity of the protocols fails to account for the importance of considering patient characteristics–such as patient’s perceptions and beliefs [ 17 ] when creating a health care plan [ 20 ] that makes practical sense in the lives of patients [ 21 ]. Patients have to do additional work to negotiate with their clinician, with their jobs, and with friends and families, Women face additional challenges as our study and others indicate that women perform more self-care activities in their daily lives [ 22 ], supported by their community and take responsibility for the self-care of husbands and family members [ 23 , 24 ].…”