How to Identify and Manage Diabetes Distress

Living with diabetes is stressful and can lead to “diabetes distress.”  Daily self-management of the disease, including glucose testing, foot care, exercise, dietary changes/food preparation, and taking multiple medications can be overwhelming. The prospect of long-term serious complications as well as concern over the quality and cost of medical care can add to the emotional burden of the disease. Complications of diabetes include:

·         Heart disease: People with Type 2 diabetes are two times more likely to develop and die from cardiovascular disease, including heart attacks, strokes, and heart failure, says the American Heart Association.[1] 

·         Chronic kidney disease: In the United States about 1 in 3 people with diabetes have diabetic nephropathy, which is chronic kidney disease (CKD).[2] 

·         Diabetic retinopathy (vision loss): The condition occurs when high blood sugar damages small blood vessels at the back of the eyes, leading to vision loss.

·         Peripheral neuropathy: Diabetic neuropathy or nerve damage is a common complication that may affect as many as half the people with diabetes.[3]

Adding to diabetes distress is worry that even adhering to the prescribed regimen of daily self-management, there is no assurance of stable blood glucose levels. As a result, since daily outcomes may vary, someone may disengage from daily care.

Diabetes distress also arises from the social impact of diabetes, which can include a stigma, discrimination and dealing with the reaction of others. People may have thoughtless reactions or attempt to provide unhelpful advice because they do not understand the disease.

Diabetes distress is common

Many people experience significant diabetes distress. About 40% of adults with either Type 1 or Type 2 diabetes report significant distress at any point in time, and over 50% report significant distress during any 12-month period. [4]

It is important to note that experiencing diabetes distress does suggest a mental illness, but it can co-exist with depression and anxiety. Diabetes distress tends not to come and go, but for most people diabetes distress persists over time without varying. [5]

Understand what are Diabetes distress symptoms

Knowing what are diabetes distress symptoms will help in seeking support. Most common are feelings of frustration burnout and stress. Situations related to diabetes that may cause stress include: [6]

·         Thoughts about food choice and eating control

·         Worry about having a low blood glucose event

·         Feeling overwhelmed by the amount of information necessary to use diabetes devices properly (pumps, continuous glucose monitors or meters)

·         Disappointment over lack of or insufficient support from friends and family

Also, there are times when diabetes distress is more likely to occur:[7]

• On initial diabetes diagnosis
• Experiencing a stressful time, for example, losing a job
• On developing a diabetes complication or another health problem
• Changing diabetes care routine, which can include change in diet or medication
• Changing healthcare provider

Diabetes distress treatment and tips

Owing to the severity of the disease, one cannot give up taking care of one’s condition yet can find ways to deal with their feelings. Tips from CDC for diabetes distress treatment are: [8]

Pay attention to feelings: Feeling overwhelmed coping with diabetes for more than a week may require outside help to feel better.

Talk to health care providers: Recognize distress and talk to doctors, nurses, diabetes educators and any other health care professionals providing care and treatment. They can help resolve concerns and may suggest other health care providers who can help.

Inquire about financial help: Explore programs that can help with costs. Among these are community health centers about programs that help people get medicine and supplies.

Talk to friends and family: Friends and family can be a major source of help in relieving stress. Be open about needing help emotionally and assisting with daily diabetes management.  

Talk to others with diabetes: Diabetic support groups online or community based can help mitigate loneliness and provide information on what works for them in dealing with their diabetes.

Take things one at a time: Focus on one task at a time to lower stress. It is not necessary to meet all goals immediately.

Do things you enjoy: Relieve stress by doing enjoyable things. Make it a point to set aside time each day to call a friend, play a game, work on a project, go for a walk or go to a movie. Take the necessary breaks to feel good.

Anyone experiencing diabetes distress should consult with their healthcare team and take steps to deal with their feelings to avoid derailing their diabetes management plan.