Marriage Keeps Your A1C Low

Married older adults have lower A1C levels than unmarried ones, according to a recent study published in BMJ Open Diabetes Research & Care. Surprisingly, even strained and unsupportive relationships show a positive effect.

Why would marriage keep your blood sugar low? Read on to learn how it might work.

The Relationship Between Social Health and Physical Health

While it may seem like one’s marital status and metabolism shouldn’t have much to do with each other, experts know that social health is very important to physical health. As the National Institutes of Health explains, “wide-ranging research suggests that strong social ties are linked to a longer life. In contrast, loneliness and social isolation are linked to poorer health, depression, and increased risk of early death.”

These associations are particularly strong for people with, or at risk of developing, type 2 diabetes. Previous studies have found that friendship and community engagement are significant diabetes risk factors. Loneliness, for example, may double the risk of type 2 diabetes.

The relationship between social and metabolic health is extremely complex, but there are likely several factors at play:

Social angst can trigger a chemical stress response, including excessive secretion of the hormone cortisol, which causes inflammation, heightened glucose levels, and insulin resistance.
Loneliness, stress, and depression can also negatively affect eating behavior, increasing sugar cravings and other poor dietary choices.
Living with a partner or spouse may help you feel more motivated to make healthy lifestyle choices. Partners can help to buffer stress, an effect that can deliver direct health benefits, such as reducing the inflammation that is highly associated with diabetes.
Marriage can also help relieve financial stress — shared income and resources can make a huge difference.

Romantic relationships may be especially important later in life, as most people have less contact with children and friends as they age.

The New Study

The new study was led by Katherine J. Ford, PhD, a postdoctoral fellow with the Department of Psychology at Ottawa’s Carleton University. Ford and her coauthor assessed several thousand English adults between the ages of 50 and 89. The study participants did not have diabetes.

(“Marriage,” for the record, doesn’t need to refer to legal marriage — respondents were counted as “married” if they lived with a partner.)

Adults in marriages (or cohabitating relationships) had an A1C that was 0.2 percentage points lower than single adults. That’s about 20% as powerful as the average A1C reduction associated with diabetes drugs like metformin or sulfonylureas.

That modest improvement has an incredible effect when it’s spread across a larger population: A 2001 Norwegian analysis quoted by Dr. Ford’s paper contended that “a population reduction of 0.2 percent A1C … would reduce total mortality by … 10 percent.”

The result was consistent in both men and women.

It’s also important to note that the researchers tried to account for confounding factors such as age, BMI, employment, and smoking status. In the sample, unmarried adults were likely to be older, smoking, and less physically active, all major known diabetes risk factors. The analysis adjusted for all of them to help isolate the effect of marriage alone.

Unhappy Relationships

Of course, we all know that bad relationships, whether with friends, family, or lovers, can have a negative effect on our mental health, increasing stress levels and driving unhealthy behavior.

Participants in the new study were asked questions about how supportive their spouses/partners were (Could they rely on them? Did they feel understood?) and how strained their relationships were (Did they get on each other’s nerves?). The researchers expected that strained and unsupportive relationships would have a less positive metabolic effect.

Surprisingly, though spousal support and spousal strain had no relationship to A1C. That is to say, people with apparently unsupportive marriages enjoyed the same blood sugar benefits as people with happy ones. It turns out that just living with a partner — even one that doesn’t seem particularly supportive — may result in the same glucose-controlling effect.

It’s tough to put too much credence into any one study, of course, and the results of an analysis of people without diabetes may not pertain to people with the condition. The authors noted that a previous study on adults with diabetes found that spousal support did matter. The authors speculated that diabetes, a serious health challenge, requires more active support.

Takeaways

Marriage may help control your A1C. A new study suggests that married older adults (without diabetes) have significantly lower blood sugar levels than unmarried ones. Even strained, less-supportive relationships seem to help.

Though this one study isn’t enough to prove that marriage has a glucose-lowering effect, it dovetails with an immense amount of medical research associating social health with physical and metabolic health. People with vibrant social lives — romance, friendship, and community involvement — tend to be healthier. They experience less physical stress and are in a good position to make healthier lifestyle decisions.

Relationships are important, especially for older adults!

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