Recently I was invited to an event to discuss how a relationship gets affected if one partner suffers from Type 1 or Type 2 diabetes. Firstly, it is important to understand diabetes as a third partner in the relationship, which is alive and present as a lifelong health condition that must be managed by both the diabetic partner and the healthy one. Having said this, managing this third partner isn’t as black and white as it seems and will need some working through for both. There are challenges that the relationship will experience and no one other than you is more physically and emotionally affected by diabetes than your partner. It’s common for the partner to worry about serious health complications, like blindness or amputations, as well as helping the partner control the disease daily and with blood sugar emergencies like low blood pressure. There is also the worry of maybe doing more in terms of taking care of family responsibilities, and financial issues, as this disease has a lifelong cost attached to it that is not affordable for all. A complete lifestyle shift is required, including making healthy choices regarding eating, exercising, and other activities.

The key to managing this is open and transparent communication between the partners that can build understanding and emotional and physical intimacy. Both need to express what they need from each other, and it will take time for them to co-organise around each other’s needs. For example, the diabetic partner might feel micromanaged or neglected while the other partner is conflicted between over-nurturing or giving space to normalise life. So, one’s actions can be misperceived by others unless there is open dialogue.

For example, the diabetic partner might express that he finds the partner overbearing when the disease is constantly being discussed or his blood sugar levels monitored.

Communication can set boundaries with your partner around how they want their medical condition to be managed and can lower the other partner’s anxiety. It’s also essential to express to each other the emotional and physical toll of managing diabetes. Tip-toeing around each other and avoiding can be a coping mechanism rooted in the belief that talking about the stress of managing this condition will be unkind. However, expressing what one is feeling authentic about is the key to being authentic and strengthening the relationship.

One can also understand that the healthy partner might feel they are making more compromises around lifestyle changes, which is probably true, so discussing their feelings is very important. And equally necessary is for the diabetic partner to validate the other’s effort and acknowledge the worry and concern associated with this health condition.

Because diabetes involves much planning, it is plausible that the relationship begins to lack spontaneity. So, it’s essential as a first step to start working towards accepting this condition as a part of life but not a barrier that can prevent both from living a fulfilling life.

The attitude toward the condition is the most important thing. It’s easier to pretend that diabetes doesn’t play a role in the relationship, but accepting that it does is the first step towards coexisting with this condition within the relationship. Don’t let it be the elephant in the room. Healthy diabetes management requires consistent attention within the relationship and needs constant, transparent discussions.

If you and your partner feel that diabetes is coming in the way of the relationship, seek couples counselling that can enable better communication and a more emotionally intimate relationship. Validate each other and acknowledge this third part of the relationship as a shared goal that, rather than being an obstacle in the relationship, can strengthen the bond and make it stronger.