Communication with non-diabetic family members may be key for African-Americans with diabetes

October 26, 2012
A new study published online in the Journal of General Internal Medicine examines interactions between African-American adults living with diabetes and their non-diabetic family members. A key finding describes ‘family diabetes silence’ as stemming from unresolved family conflict, role confusion and concerns about not knowing what to say to family members living with diabetes.

Dr. Carmen Samuel-Hodge

Dr. Carmen Samuel-Hodge

According to the analysis led by Carmen Samuel-Hodge, PhD, research assistant professor of nutrition at the UNC Gillings School of Global Public Health, patients with diabetes report conflicts related to family advice-giving and adjustment of family roles to accommodate diabetes. Non-diabetic family members described discomfort related to policing the diabetic family member, not wanting to make the disease a central and perhaps hurtful issue in their interactions, perceiving that their communication was unhelpful and being confused about their role in diabetes care.

“While studies have focused on family roles and interactions from the perspective of persons with diabetes,” Samuel-Hodge and her colleagues wrote, “little to no attention has been given to understanding the views of non-diabetic family members who live or regularly interact with diabetic family members. By exploring family diabetes interactions from the perspective of adult family members not diagnosed with diabetes, we potentially gain a broader view of the interactions that may impact diabetes management in African-American families.”

With the intent of gathering information to design a family-based intervention for African-American adults with diabetes, Samuel-Hodge and her colleagues conducted focus groups with 67 African-American adults who gathered in eight groups–four of which included diabetes patients and four including family members not diagnosed with diabetes. Group discussions focused on how diabetes changes family life, and how family members react to these changes in the way they communicate, handle the conflicts that arise and support family members living with diabetes.

The study found that diabetes silence, role adjustments and conflict are important aspects to address in family-centered diabetes self-management interventions. “This exposure to the views of non-diabetic family members creates opportunities for informing new intervention approaches to address both risk reduction and enhanced diabetes self-management support in African-American families living with diabetes,” Samuel-Hodge concluded.

Co-authors include Crystal W. Cené, MD, MPH, assistant professor in the UNC School of Medicine; Leonor Corsino, MD, MHS, instructor and physician at Duke University’s Division of Endocrinology and Metabolism; Chelsea Thomas, MPH, UNC Center for Health Promotion and Disease Prevention; and Laura P. Svetkey, MD, MHS, director of clinical research at Duke University’s Sarah W. Stedman Nutrition and Metabolism Center.

Samuel-Hodge is also a research fellow at the UNC Center for Health Promotion and Disease Prevention, where she leads several research projects in North Carolina, using behavioral lifestyle interventions for diabetes self-management and obesity treatment.




UNC Gillings School of Global Public Health contact: Linda Kastleman, communications editor, (919) 966-8317 or