Table 2 Summary of the included studies

Trief et al. [41]. Describing support: a qualitative study of couples living with diabetes

USA

To learn about support from couples who deal with diabetes daily

Grounded Theory and telephone interviews

40 patients (55% type 2 diabetes) and 32 spouses. Mean age patient and spouse 49 years

Three broad topics on spousal behaviour and diabetes management: (1) being helpful, especially regarding diet, general support and reminders, (2) being non-helpful, including nagging, wrong diet, poor communication and conflicts, (3) couple interaction as teamwork, independence, emotional support

Sandberg et al. [42]. “He said, She said”: the impact of gender on spousal support in diabetes management

USA

To examine how gender is related to support for couples coping with diabetes

Grounded Theory and individual interviews

40 patients (55% type 2 diabetes) and 32 spouses. Mean age patient and spouse 49 years

Both males and females recognised the importance of spousal support. Males used more authoritative language, females more accommodating and collaborative. Females preferred verbal support, males instrumental. Females identified own nagging, males silent

Stephens et al. [45]. Spouses’ attempt to regulate day-to-day dietary adherence among patients with type 2 diabetes

USA

To investigate daily dietary adherence in older adults with type 2 diabetes as a function of spouses’ diet related support and control

Quantitative study using diaries and questionnaires

126 couples where one partner had type 2 diabetes. Mean age 66 years

Spousal dietary support increased patient adherence, whereas persuasion and pressure decreased adherence. Support decreased distress and pressure increased distress and decreased adherence

Houston-Barrett et al. [43]. Couple’s relationship with diabetes: means and meanings for management success

USA

To develop a theory about dyadic constructs and their interactions with success in diabetes management

Grounded Theory and dyadic interviews

25 couples, one with type 2 diabetes, mean age men 57 and women 55 years

Relationships with diabetes: (1) transforming, (2) accepting, (3) rejecting. Couple’s relationship to diabetes determines success. Focus on emotion and meaning leads to growth, accept or rejection

Dimitraki et al. [44]. The association of type 2 diabetes patient and spouse illness representation with their well-being: a dyadic approach

Greece

To examine type 2 diabetes in patients and spouses in relation to physical and psychological well-being

Quantitative study using questionnaires

84 couples where one partner had type 2 diabetes. Mean age patients 65 and spouse 63 years

Synergy between patient and spouse; patients had anxiety and depression when spouse perceived diabetes as unpredictable. Spouses had anxiety when patient perceived diabetes less burdensome