Your spouse can ‘give’ you diabetes, say experts

By Gatonye Gathura

Kenya: Spouses whose partners are diabetic should go for screening because they face a higher risk of ‘catching’ it as well. Medical researchers are now telling such couples, and especially men with poor health care seeking behaviour, that diabetes is a “network” disease and can spread from one family member to another.

This is because diabetes is known to walk along genetic pathways, Dr Kaberi Dasgupta of McGill University, Canada, says.

“If one parent is diabetic, there is a chance that the children could “catch” it, but if mother and father both have it then the  chances that the children will develop diabetes is even much higher,” Dr Dasgupta says. For the first time, she introduces the phrase diabetic discordant couples.

The word discordant has so far been associated with HIV where one partner is infected and the other one remains free of the virus. However, the uninfected person must take precautions because the partner can always transmit the virus to them.

The McGill team considered more than 70,000 couples across the world, including Africans, and concluded that in a marriage where one spouse is diabetic the other one has a two-fold risk of getting the disease.

This is because couples may share similar habits, especially in what they eat and drink . . . the amount of physical activity they prefer is also quite similar. While diabetes is not infectious, they say, lifestyle habits are and nowhere else does this play best than among couples,

Fifty-seven-year-old John Sholito, a diabetic accountant in Nairobi and who is reluctant to drag his family into this discussion, says their child was the first to be diagnosed with the disease,   then the mother and now himself.

“In my reading I learnt that diabetes can be hereditary or aggravated by a personal lifestyle and when this happened to us, I began to wonder if I was somehow biologically related to my wife,” the accountant told this writer while stubbornly nursing a glassful of the now controversial quail eggs.

What has struck Sholito and thousands of other Kenyan families is an emerging lifestyle medical condition that the McGill team calls ‘spousal diabetes’.

“Contributory factors may include similarities in dietary composition and food environment, physical activity, cigarette smoking and alcohol consumption,” wrote the team in the online journal BMC Medicine last month.

Again urban couples face the greatest risk of “contracting” spousal diabetes with the shift in food consumption from home-prepared regular meals to erratic and purchased meals that are energy-dense.

One aspect the 2010 Alcohol Control Act or the Mututho Law sought to remedy was not just overconsumption of alcohol, but the dragging along of children to the bar for roast meat or salty, sugary and fatty snacks.

This typical family, mainly headed by a member of the middle class, will drive to and from a sedentary job, settle for an evening drink and retire at home to catch up with the daily happenings on television, and all this on a repetitive basis.

“It is a recipe for obesity, diabetes and, of course, heart diseases,” says Dr Vincent Onywera of the Department of Recreation Management and Exercise Science at Kenyatta University.

Next month Dr Onywera will be releasing Kenya’s 2014 Report Card on Physical Activity and Body Weight of Children and Youth that he says highlights very worrying trends, especially for urban families.

The last such report was released in 2011 and demonstrated that children were walking less, eating more junk food and were less healthy compared to previous generations.

Dr Onywera, who authored this report, warned that children faced a higher risk of developing chronic lifestyle diseases such diabetes because they barely engage in physical activity.

The new report, to be released at the end of March in Maputo, Mozambique, will show whether the situation in Kenya has changed since 2011.

The most likely scenario is that the situation is worse, says   Dr Regina W. Mbochi of Kenyatta University who sampled the feeding habits of 365 women in Nairobi and concluded most seemed to have a death wish.

In her sample, Dr Mbochi and a team from the Human Sciences Research Council of South Africa found that 70 per cent of affluent women consumed alcohol compared to only 12 per cent of their poorer counterparts.

Richer women were found to be more likely to consume refined foods such as white rice, more eggs and meat and sugary foods, including ice cream while taking less of vegetables such as kales and cabbages compared to poorer females.

The bottom line is that women with higher incomes were found to be much more likely to be overweight or even obese.

Drawing a link between obesity and wealth, the team found that the number of rooms in a Nairobi home is the first indication to the size of adult women in the home.

The more rooms there are in the house the more likely the older women would have big waistlines, carry a lot of fat and are big domestic spenders compared to females living in fewer roomed houses in the city.

If you enter the kitchen of one of these homes, you are most likely to find a high presence of beef, chicken, processed meats and eggs, say the five researchers.

The most significant predictors of overweight and obesity, says the study published in the journal BMC Public Health, were age and the number of items or assets in the women’s households.

According to the researchers such household items included television and radio sets, a refrigerator, a cooker with an oven, sofa sets, microwave ovens, home computers, mobile phones and a telephone landline. Most of these women owned property, it was noted.

What Dr Mbochi did not do then is to wait for the men of the houses to return home and compare the size of their waistlines with those of the females.

But the new McGill study says it is likely that most men in such homes covered by Dr Mbochi’s study would have been obese, especially if they had been married to the same partner for a long time.

“Spouses may shape one another’s behaviours over time contributing to diabetes concordance,” wrote Dr Dasgupta.

In what could make the McGill report a must-read for the many relationship and marriage counsellors in Kenya is the argument that risky behaviour towards obesity, for example,  may be present long before a couple is married.

Going by the study, relationship counsellors could add to their list of what to look for while choosing a lifetime partner. For example they could warn: If you notice the other likes too much alcohol, tobacco and fatty, salty and sugary foods and does not exercise, know you are at the risk of diabetic ‘infection’.

But the team also adds another angle as to why spousal diabetes could be much more prevalent than previously thought—they used the aphorism “birds of a feather are most likely to flock together”.

“Shared habits may be present already at the time of marriage, wherein individuals with similar physical, for example, body size or social class and even physical activity behaviours are most likely to become partners,” argues Dr Dasgupta.

The team is now telling doctors and other health care workers 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.

“It is important to be our brother’s keeper and adopt safer lifestyles at home, in school and the workplace,” advises Dr Onywera.