Out of Love

| Jan 12, 2010

Dear Diabetes Health, I hope you can help me. I am 49 years old and was diagnosed with type 2 five years ago.  My husband still wants sex. I don't even want him to touch me.  He is very mean to me. He yells at me and calls me names.

My sugar control is pretty good. My A1C is about 7%. I'm about 20 pounds over where the doctor wants me, but my girlfriend tells me I still look good.  But my husband calls me "his little piggy" and worse things. Then he wants sex!  

We always had some problems, but he didn't used to be this way until the last few years. We've been together 18 years, and I used to love him. What can I do?


Dear Marguerite,

You are in a tough situation, and we give you credit for managing your diabetes well despite your husband's attitude. Insults are a bad sign for a marriage. Possibly he is involved with someone else or wants to be.  Perhaps diabetes just makes him too uncomfortable. But your 18 years together counts for something, too.  Possibly you can turn things around.

Let's start with your communication, which has broken down. Try talking to him in "I" messages. That means talking about your feelings and how his actions affect you, instead of focusing on what he is doing wrong. You can say something like, "It really hurts me when you call me names like ‘Piggy'.  It doesn't help me do better; it just makes me want to give up.  Could you please call me [something more positive]?" That's called "assertiveness," (standing up for yourself) and it often works.

It sounds as though neither you nor your husband feel loved. Gary Chapman PhD, author of The Five Love Languages, says that we all have "love tanks" that need to be filled.  When our love tank stays empty, it is hard for us to act positively towards our partners.  Many times, this is a problem of communication - each partner may be giving love in a way (a "love language") that the other doesn't understand. It may be that you were giving him love in a language he didn't understand. It is even possible that he occasionally tries to give you love, but he isn't speaking your language.

Chapman says there are five love languages: words, gifts, touch, acts of service, and "quality time," which we call "undivided attention." Few people "speak" all five, but it's important to be at least bilingual - to give and receive love in your main language and your husband's. For example, he might feel that he is giving love by working hard to provide, while what you want is some undivided attention. Or you might give love by providing him with attention, when what he wants is more touch.  Or something - as you can see, there are many ways to miss each other.  The key is to learn your partner's language, so you can give love in a way he can take in, and feel any love that he is trying to give you.  

Dr. Chapman advises spouses in your situation to say something like, "I want to be a better wife (or husband) to you.  If you have any suggestions that would help me be a better [spouse], I am open to them. You can tell me now or think about it and tell me later." Try to act on the advice he gives you, and ask him for feedback every week on how you are doing.

This is hard to do, we know. It should be him saying those things to you, but he's not going to. So it's up to you. Check out Dr. Chapman's web site for more on this.

When it comes to sex, don't do something you don't want to do. But it would be good if you could get to a place of wanting some.  Think about what would make you interested in sex with him, and ask him for it.  Or remember the things about him that used to turn you on, and try to focus on those. Look at some of our previous columns for ideas on boosting your desire and finding sexual activities you might like.

Dr. Chapman says that giving sex can be an act of love, which you can give whether you actually feel love for the other person or not.  You're just doing something good for them, giving a gift.  (As a religious counselor, Chapman is talking about giving sex in the context of marriage. We would say people can give love in this way to other people as well.)     

Reconnecting is going to be a long process, and you might want to get professional help from a counselor or clergy. And keep taking care of yourself! With better communication and the right love language you might be able to fix this.  Let us know how it goes.

We've got a new web site.  Check out our programs for couples at http://coupleswellness.sitesvp.com

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Categories: A1c Test, Columns, Diabetes, Diabetes, Sexual Issues, Type 1 Issues, Type 2 Issues, Weight Loss

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Posted by Steve Parker, M.D. on 12 January 2010

I've read "The Five Love Languages" and heartily endorse it. Great book for anyone wanting to improve relationships with people close to them.


Posted by mgordon on 12 January 2010

Stop letting him mark you down like a bargin basement shirt and demand respect. Piggy is not your name, therefore don't respond. Don't laugh either. Laughing means yiou condon the insult

Posted by seashore on 12 January 2010

An A1c of 7% is not a healthy number, regardless of what diabetes "authorities" often claim. You should keep A1c well below 6%.

You can greatly improve your own health by going onto a low-carb diet. Limit carbs to 30 grams (about one ounce) per day. Then take whatever diabetic medication is needed to keep peak blood sugar below 140 mg/dl after every meal. Peak blood sugar occurs about one hour after eating. The International Diabetes Federation reported that significant diabetic damage occurs whenever p;eak blood sugar exceeds 140 mg/dl.

These measures will greatly reduce your weight and improve your health. After that, they may well improve your marriage.

Posted by Anonymous on 12 January 2010

How does this issue relate to diabetes? For relationship issues, I suggest a marriage counselor... or seek individual therapy if he does not want to participate in counseling.

Posted by Anonymous on 13 January 2010

She should kick that clod of dirt to the curb. He can only be abusive if you let him. So stop.

Posted by Anonymous on 13 January 2010

I have also read "The Five Love Languages", it is a good book. I am a type 1 diabetic of 15+ years.

In my opinion, your sex problems are unrelated to diabetes -- the problems you raise are marriage problems in general, and need to be dealt with accordingly. If you are Christian, I would recommend both the "The Five Love Languages" by Chapman, but I recommend far more strongly "Marriage: A Taste of Heaven" two volume set by Patsy Rae Dawson (you can find it at www.gospelthemes.com)

"Patsy's materials are such a radical divergence from everything else on the market. Imagine going straight to God's word for help and healing in your marriage….what a novel idea!!!!" (Christian)

My prayers are for you, that you and your husband will work through the difficulty together, trusting God for answers. Don't think that your problems are due to diabetes.

Posted by Anonymous on 13 January 2010

I am sorry, but his behavior is verbal and emotional abuse. I would recommend that you seek marriage counseling for you both, and if he will not go, go by yourself. 18 years counts for something, but take it from someone who has "been there, done that", if he is not made to see the abuse and forced to change his behavior, he will not. In 18 more years, will it be any easier to leave? I wasted 10 good years in an emotionally and sometimes physically abusive relationship. Do not waste another moment. Life is too short to be miserable. Get it fixed, or cut your losses and get out. You are worth it, and you deserve to be happy.

Posted by Anonymous on 13 January 2010

"(As a religious counselor, Chapman is talking about giving sex in the context of marriage. We would say people can give love in this way to other people as well.)" What an irresponsible thing to say, Sex is not a gift to give other people!!! It is not like Christmas cards to be doled out to everyone! You may want to rephrase this sentence, as I am sure you did not mean that we should be "swingers". I heartily agree with Dr. Chapman, sex is to be enjoyed within the context of marriage. It is in the Bibble.

Posted by whimsy2 on 13 January 2010

The obvious answer is get help. You both need to see a therapist (not necessarily together). If he won't go, get therapy for yourself.

Posted by Twilight on 13 January 2010

As a Certified Diabetes Educator/RN I disagree with seashore's 30 grams of carbs a day. We need carbs for energy so women need 3 meals of at least 45 grams and a 30 gram snack; too much protein can lead to kidney damage. Blood pressure medication and depression can also be causes for low sexual desire and compounded by your hubby's attitude. Good luck & stay positive.

Posted by Anonymous on 13 January 2010

In addition to his negative approach, consider that at 49 she is perimenopausal and her testosterone levels are likely half of what they were in her 20's effecting sex drive and response and other hormones changing affecting sense of well being and various other physical effects.

Posted by Green Lantern on 13 January 2010

Excellent article, and very compassionate advice. Twilight, 30 grams of carbs does seem unrealistically low. But 160 grams of carbs per day is HIGH, even for a non-diabetic! The body has NO carbohydrate requirement, and, in fact, is meant to burn FAT for everyday fuel, and glycogen only in times of dire need (i.e., racing away from a predator). The ADA has done this country a huge disservice by pushing 160 grams of carbs/day as "low". In fact, this advice has contributed to the diabetes epidemic, and serves only the food lobbies that push cheap grain-based foods.

PLEASE try reading the Rosedale Diet and Mastering Leptin to learn how the body is supposed to work. I was prediabetic, and with Rosedale lost 25 lbs. 3 years ago, increased my muscle mass, and now have normal glucose metabolism. I try for a max of 60 grams of carbs/day. It works!

Posted by cde on 13 January 2010

Seashore is right on, well, 90% right on. Actually, post-meal BG could properly be less than 110 mg/dL (in the worst case scenario) and less than 100 mg/dL (in the best case scenario). Either way, the A1c would be far less than "about 7%."

Also, the study by Imo et al, showed that retinopathy BEGINS at around 126 mg/dL (not 140 mg/dL).

Reducing your weight, your A1c, and increasing your health (emotional and physical) are not always easy, but they can be done, and, as Seashore suggests, they pay off handsomely.

Twilight, I don't want to preach (I am also a CDE, in México), but you might enjoy reading the original articles about protein consumption and the production of kidney damage. To date, NONE has shown that this nephropathy is actually produced by protein ingestion (except in myth, misinformation, and miseducation). If someone already has kidney disease, the recommendations are different, depending on the clinician.

On another note, the lack of wish for sex ("He/she wants sex, but I don't.") can at times also reflect DM complications. In women, as well as in men.

Dr. Stan De Loach
México, D. F.

Posted by Anonymous on 14 January 2010

Love and Respect. This sounds like the big issue here to me. Emmerson Eggerich has done a lot of study in this area. He has a book and marriage conference (turned into DVDs). The main gist of it is that men need a majority of respect and women need a majority of love. When a man does not feel respected (often because of a "respect language" that's not right/ you may feel like you're respecting him, but he doesn't feel you are), he doesn't give love. And when a woman doesn't feel loved (for the same reason a man doesn't feel respected, that language barrier), she doesn't give respect. A wife and husband can easily put up walls because of this. The diabetes just adds another drop to the mix.
But it works the opposite way as well. When a man feels respected, he wants to love. And when a woman feels loved, she wants to give respect.

Fireproof, the movie, is based on a book called The Love Dare by Stephen and Alex Kendrick. It's a 40 day challenge to begin loving your spouse again. And it's amazing. Marguerite, you said that you used to love your husband... A lot of this book focuses on how you can love again, in a better way, in a more unconditional way. I challenge you to take this love dare. You'll start seeing your husband for the man that God created him to be, and what good characteristics he has, rather than what flaws and bad characteristics he portrays.

Don't give up! It might be tough for a while, as it already has been for a time, but you can start working on what's broken between you and your husband. I'll be praying for you, dear.

Posted by Anonymous on 18 January 2010

This is a classic example of how diabetes can effect relationships. I agree with the suggestions that you should never tolerate anyone disrespecting you with mean or insulting names and/or comments, especially your significant other. That is a priority and critical in restoring your self esteem which is likely the underlying cause of the demise of the passion in your relationship. Your next priority is to reshape the focus to rebuilding YOU! In the long run, your husband will be much more attracted to a confident and healthy YOU! Start a simple (20-30 minutes per day 4-5 days per week) exercise program with a vision of slowly but surely evolving into a athletic person with diabetes. This will effect your weight and your diet and the way you feel and look at yourself which will show up in your self esteem and decreasing the risk of depression. It will also optimize your glucose control as you adjust your diabetes medicine (work closely with your diabetes clinical management team for medicinal adjustment and diet modification). The next priority is to become a diabetes self-expert by reading everything you can about diabetes. One good book to obtain is "50 Secrets of the Longest Living People with Diabetes" by Sheri Colberg and Steve Edelman. In the end, by shifting the focus to improving your vision of yourself you will either expose your husband for the fraud that he may be (he may actually dislike himself and be taking his dissatisfaction out on you) or you will reel him in to being more attracted than ever to a confident, sexier you.

Posted by drmitaljohn on 1 February 2010

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