Spousal diabetes associated with personal increase in diabetes risk

Having a spouse with diabetes was associated with a 26% increase in personal diabetes risk, according to a recent study.

Researchers performed a systematic review and meta-analysis to evaluate diabetes concordance in spouses and the effect of socioenvironmental factors on diabetes risk. Cross-sectional, case-control and cohort studies that looked at spousal association and diabetes, prediabetes or both and were published from Jan. 1, 1997, to Feb. 28, 2013, were considered for inclusion. The study was published online by BMC Medicine on Jan. 24.

Six studies were included in the systematic review, and of these, 5 studies involving 75,498 couples were included in the meta-analysis. The mean age of study participants ranged from 52 years to 74 years. One study that used women's self-reports of their own and their spouses' diabetes found the lowest concordance (effect estimate, 1.1; 95% CI, 1.0 to 1.30), and 1 study that systematically assessed glucose tolerance found the highest concordance (effect estimate, 2.11; 95% CI, 1.74 to 5.10). The random-effects pooled estimate was 1.26 (95% CI, 1.08 to 1.45) in patients with a spousal history of diabetes when adjusted for age and other covariates besides BMI; it was 1.18 (95% CI, 0.97 to 1.40) when adjustment for BMI was included. High concordance was also reported in 2 studies that used glucose testing for prediabetes and diabetes (odds ratios, 2.32 with BMI adjustment [95% CI, 1.87 to 3.98] and 1.92 [95% CI, 1.55 to 2.37] without).

The authors noted that 2 studies did not distinguish between type 1 and type 2 diabetes but said this probably did not influence their results since most adults have the latter. In addition, they said, the included studies differed in populations, design, and other characteristics, and spouses of diabetics may have been more likely to recognize and seek treatment for signs and symptoms of diabetes, among other limitations. However, they concluded that according to their results, spousal history of diabetes or prediabetes may increase personal risk of the disease by 26%.

“Recognizing shared couple risk may result in greater support and collaboration within the family to engage in diabetes prevention efforts,” the authors wrote. “Physicians and other health care professionals may use this information to encourage couple-based interventions to adopt a balanced dietary intake that is not energy-dense, make healthier food choices, and increase physical activity levels.” They also suggested that spousal history be added to existing clinical evaluation and risk assessment tools for diabetes.