A study published online in the journal Nature suggests that people who live with a spouse are more likely to be healthy in terms of maintaining low blood sugar levels regardless of how harmonious or intense their relationship is. BMJ Open Diabetes Research & Care.
Researchers believe that having a cohabiting spouse or partner may be an important relationship, source of social support, and/or stress for midlife to later adults for their health.
Previous studies have indicated that there are health benefits from marriage and/or cohabitation, particularly for older adults. There are also several studies that conclude that the risk of developing type 2 diabetes is associated with a number of dimensions of social health including social isolation, loneliness, living arrangements, social support, and social network size.
However, the effects of each specific social health dimension are complex, so a team of researchers from Luxembourg and Canada set out to investigate whether marital status and social quality correlate with average blood sugar levels in older adults.
They used vital sign data from the English Longitudinal Study of Aging (ELSA) – a population-based sample of adults aged 50 years and over and their partners, living in England, from whom data were collected every two years, with vital sign data collected in every other wave.
The data used in the study was on 3,335 adults ages 50 to 89 with no prior diagnosis of diabetes during a period from 2004 to 2013.
The sample was people without pre-existing diabetes who were between the ages of 50 and 89 in Wave 2 (2004-2005) – when biomarker data were first available in the ELSA. Pre-existing diabetes was determined by self-reporting.
Participants were invited to visit a nurse after the main interview in waves 2 (2004-05), 4 (2008-09), and 6 (2012-13) and blood samples were taken to measure HbA1c (mean blood sugar, or blood glucose) levels.
Respondents were also asked if they had a spouse or partner they lived with and asked questions designed to measure the level of social stress and social support within a marital/cohabiting relationship.
Information was also collected on several factors such as details about age, income, employment, smoking, physical activity, depression, body mass index (BMI), and other types of social relationships in their social network (child, other immediate family, and friend).
The data showed that in wave 2 (2004-2005), about three-quarters (76%) of respondents were married/cohabiting.
Analysis of the data over time showed that people who experienced marital transitions (such as divorce) also experienced significant changes in their HbA1c levels and odds of developing prediabetes.
However, relationship quality made no significant difference to average blood glucose levels, suggesting that having a supportive or stressful relationship was less important than just having a relationship at all.
This was an observational study and, as such, cannot prove why. In fact, the study had some limitations such as the fact that there were a large number of ELSA dropouts between waves with vital sign data. More than half of the wave 2 sample had no follow-up data and were therefore excluded. There was also the possibility that those people in worse health were more likely to get divorced.
However, the authors argued that strengths of their study included the use of HbA1c as an outcome measure against self-reported diagnoses—the former being a more accurate and accurate measure when used in population-based surveys than diagnosed medical conditions, which depend on participants. Obtain appropriate health care before enrolling in the study.
The authors concluded: “Overall, our results indicated that marital/cohabitation relationships were inversely related to HbA1c levels regardless of dimensions of marital support or stress. Similarly, these relationships appeared to have a protective effect against HbA1c levels above the prediabetic threshold.
“Increasing support for older adults experiencing marital/cohabiting relationship loss through divorce or bereavement, as well as dismantling negative stereotypes about romantic relationships in later life, may be starting points for addressing health risks, more specifically deteriorating glycemic regulation.” Associated with marital shifts in the elderly.
Ford, KJ & Robitaille, A., (2023) How amazing is your love? Separating the role of marital status and quality on average blood glucose levels among adults 50 years of age and older in the English Longitudinal Study of Aging. BMJ Open Diabetes Research & Care. doi.org/10.1136/bmjdrc-2022-003080.