What do you consider the most important piece of your diabetes management? Exercise? Food choices? Medications and medical care? Monitoring? Your firsthand experience likely tells you that all of these things make a difference. However, underneath these layers is often another critical piece to diabetes —relational health. Importantly, it can be a driver for many of the things above.
What Is Relational Health?
Relational health is often referenced in childhood studies and by psychologists working in attachment theories. It is a framework for understanding how relationships and social interactions contribute to your health and development over your lifetime. Relational health is often closely aligned with social connectedness (the number of relationships you have, what needs those relationships fill, and the amount of positive interactions those relationships bring).
Relational Health and Your Health
We’re meant to be social— to be connected, to depend on, and to help others. Inconsistent caregiving, neglect, abuse, chronic stress, loneliness, trauma –both in childhood and adulthood—can make it difficult for you to find, stay connected to, and feel supported by others.
Many studies explore these experiences (and the social disconnection they can create) with changes in the body, such as inflammation and long-term activation of your stress response system. For example, one study showed social isolation increased the risk for high blood pressure more than traditional risk factors like diabetes and old age. The same study showed social ties were as important in reducing chronic inflammation as physical activity.
Decades of research have shown links between poor social connection and conditions like heart disease, kidney disease, diabetes, anxiety and depression, dementia, and more. The risk of heart disease and stroke is nearly 30% higher in those who are lonely or socially isolated. The U.S. Surgeon General has repeatedly stressed the dangers of loneliness— calling social connection “as essential to our long-term survival as food and water.”
Relational Health and Diabetes
If you’ve ever read about T2D risk factors, I’d bet relational health wasn’t included. Yet, poor relationships and support systems due to trauma, chronic stress, or mental health struggles increase the risk of T2D. Beyond an increased risk for T2D, you also may have noticed just how many similarities there are between the negative impacts of loneliness and diabetes complications: heart disease, stroke, kidney disease, depression. Add a complication into the mix and it can further affect your ability to connect with others and manage your diabetes well.
Diabetes itself can be an isolating medical condition. Socially there’s a lot of shame and blame around having diabetes. It can feel like family or friends try to police you or just don’t “get it.” Medical professionals may give recommendations that create further isolation (ex: food and social events). Sometimes there’s even a disconnect between other people with diabetes— the wide range of technologies and treatment options, as well as the stigma of complications, can create separation.
When you’re socially disconnected, it affects your health habits—including your diabetes management routines. On the flip side, many studies have shown high levels of social support improve health habits, blood sugars, and diabetes self-care habits.
Creating Connections – A Path Forward
I’d be shocked if you regularly considered relational health or social connections as an important part of your diabetes management plan. Yet, as you can see above, it drives how you make decisions, care for yourself, cope with stressful events, and more. There are a number of great ways to start building up your social support systems. Here are a couple of places to begin:
Learn More about Yourself, Your Family, and Relational Health
Some books that may get you started include, “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Bessel Van Del Kolk and “What Happened to You?: Conversations on Trauma, Resilience, and Healing,” by Dr Bruce Perry & Oprah Winfrey. If you were exposed to traumas or stressors in childhood, building relationships may be more difficult for you. Trauma therapists are equipped to help you navigate what you experienced and begin the process of learning to connect to others again.
Find Ways to Connect to Others
Consider volunteer opportunities or joining local community groups. These can be anything from religious-related activities to chess clubs, to library or school events. Even veteran’s groups, women’s or men’s groups, food banks, shelters, animal shelters, and more. The list of needs within a community is often endless. Make an effort to put a scheduled connection time with others on the calendar (breakfast with a friend, a family game night, a letter exchange or video call with distant friends or family). The U.S. Surgeon General has some great suggestions as well— check out some of his ideas here. Other great places to start are the Center for Disease Control and Prevention as well as the National Institute on Aging.
Make Your Diabetes Management a Group Effort
Instead of walking alone, ask a neighbor, coworker, or friend to join you, or join a group fitness class. Ask a friend or family member to go to your appointments with you. Ask about diabetes support groups in your area. The online diabetes community is a great resource as well. Tell your friends or family what you need from them— and give them the gift of letting them help you. Try a new cooking class at the local community college. Attend a diabetes conference, like TCOYD®, where you’ll meet others living and learning about diabetes right along with you.
Additional Resources:
A Volleyball Named Wilson and Diabetes Isolation
Newly Diagnosed with Type 1 Diabetes? 3 Tips from a T1D Therapist Who Gets It!
How to Lead a More Joy-Filled Life: 5 Tips for Women* Living with Diabetes
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