(REUTERS HEALTH)
Marriage has been linked to health benefits, especially happy marriage, but when it comes to developing or controlling type 2 diabetes, marriage quality seems to have opposite effects on men and women, according to a U.S. study.

For women, a happier marriage meant lower risk of developing diabetes over a five-year period, but for men, declining marriage quality was tied to lower risk of diabetes and better control of the condition for those who had it, researchers found.

"The results for men suggesting that an increase in negative marital quality is related to lower risk of developing diabetes and higher chance of controlling diabetes are surprising," said lead author Hui Liu of the department of sociology at Michigan State University in East Lansing.

A good marriage may provide a source of emotional and social support and help to reduce stress for women, who are more sensitive to stress than men, Liu told Reuters Health by e-mail.

"Wives are more likely than husbands to regulate the spouses' health behaviors," reminding their husband to quit smoking, eat healthier and take medication, which may promote the husbands' health but at the same time may also increase marital strain, she said.

The researchers looked at data from two national surveys, in 2005 and 2010, and focused on 1,228 married people aged 57 to 84 years who participated in both waves.

Each time, the men and women answered questions about closeness, happiness and emotional satisfaction in their marriages, how much of their free time they prefer to spend with their spouse and how often their spouse made too many demands on them.

Participants also had lab tests in 2005 and again in 2010. In the first wave, 389 people, or 19 percent of the whole group, had type 2 diabetes based on formal diagnosis or on blood sugar levels at the time. In 2010, 30 percent of participants were diabetic.

For women, an increase in reported marriage quality between 2005 and 2010 was tied to a lower risk of having diabetes in 2010. But for men, an increase in negative marital quality was associated with lower risk of having diabetes in 2010 and a higher chance of controlling diabetes in 2010, according to the results in the Journals of Gerontology Series B: Psychological Sciences and Social Sciences.

It’s unclear if marriage quality causes changes in diabetes management or if the two are related in some other way, Liu said.

In a previous study, Liu found that poorer marital quality is related to higher risk of cardiovascular disease for women, but not men.

"Some forms of marital strain can be protective, but support can be stifling," said Deborah Carr, professor of sociology at Rutgers University in New Brunswick, New Jersey, who was not part of the new study.

"Marital conflict doesn’t necessarily mean tension and discord, it can be squabbles over things like, ‘why didn’t you take your meds?’," Carr told Reuters Health.

This paper and most others accounted for other factors like race, age, socioeconomic status and other physical health conditions, Carr said.

For older men with a health condition, "being supported and coddled might actually be anxiety provoking," she said.

"For women, improving marital quality may help to reduce the risk of diabetes," Liu said. "For men, wives' nagging on health behaviors may be good for their health."

It’s a very rare patient who is wholly responsible for their own health, Carr said.

"It’s important for healthcare providers to get a sense of what marriage is like and important for spouses to go to doctor appointments together," she said.

SOURCE: "Journals of Gerontology Series B: Psychological Sciences and Social Sciences," online May 23, 2016.