Psychosocial Aspects of Diabetes

Diabetes is a disease that affects every aspect of your life, from family to friends, work, how you participate in activities, what you eat and how you feel physically and emotionally. Diabetes requires 24/7 attention with no vacations, so it should not be a surprise that most people living with diabetes have challenges emotionally and/or socially at one time or another. It is also not surprising that people with diabetes are twice as likely to have serious psychological distress compared to people without diabetes.

Stress, worry, feeling down, sadness, burn out, overwhelmed, embarrassment, shame, and frustration are common feelings people with diabetes experience. This is why addressing the social, emotional, and psychological aspects of diabetes and its complications are just as important as educating patients on how to manage their blood sugar.

Depression, anxiety, and other disorders causing serious psychological distress are associated with poorer medical outcomes as well as a decreased quality of life (QOL).

Emotions and stress can increase blood sugars alone. Combine that with a person feeling burned out, depressed, or anxious can lead to a lack of motivation to take care of themselves or forgetting to take their medication and/or insulin and check their blood sugars.

So, taking care of yourself psychologically/emotionally can improve your health.

Diabetes care includes psychological care

The psychosocial aspects of diabetes management play such an important role in the health outcomes and quality of life for people, that the American Diabetes Association (ADA) has made it a Standard of Diabetes Care for all clinicians to talk to patients about how they are doing emotionally/psychologically and assess for any issues that may need a referral to a mental health professional trained in diabetes.

They recommend that, “Psychosocial care should be integrated with collaborative, patient-centered medical care and provided to all people with diabetes…”

Specifically, ADA recommends that clinicians assess patients for diabetes distress, depression, anxiety, and disordered eating at their initial visit, when there is a change in their diabetes management (e.g., development or progression of complications), change in treatment, or a change in life circumstances (e.g., loss of job, death of a loved one, divorce, etc.), and periodically throughout the course of treatment.

The guidelines recommend that clinicians should include family members and caregivers in assessing their patient’s well-being. If healthcare providers find that a person is experiencing emotional/psychological symptoms, getting help and support early is recommended so these issues don’t get worse and interfere with someone’s day-to-day functioning and/or management of their health conditions.

It is easier and more effective to treat psychological issues early on than when they have progressed into more serious challenges.

Support from family and friends is important

If you are feeling lonely, stressed out, worried, burned out and unmotivated, or even just overwhelmed with all you must do in life plus the added stress and responsibility of managing your health, getting support from family and friends is important.

If you feel embarrassed about confiding in family or friends or you don’t want to burden them, then getting support from diabetes support groups or reaching out to your healthcare providers about how you are feeling and your worries is important.

Your health care providers can connect you to a mental health care provider or you can find a mental health care provider that specializes in diabetes here: Mental Health Provider Directory Listing | American Diabetes Association.

Seek help from other people who have diabetes

Getting involved with groups of people who also have diabetes can also be helpful.

Other people with diabetes know what you are going through, so when you say you are feeling sad, angry, or frustrated about something they understand and can be supportive in a way your friends and family without diabetes can’t.

You could ask your healthcare provider and/or local hospital if they have a list of diabetes support groups in your area.

To find online diabetes support communities go to:

Key take-aways

The emotional toll and physical consequences of diabetes affect every aspect of a person’s life. Having an emotional response is very common and normal.

If a person didn’t have an emotional response that would be unusual. Emotions and worries come and go and are part of everyone’s experience.

When your emotions or diabetes management become too overwhelming and start having an impact on how you are functioning and/or your health is deteriorating because of it, that is the time to do something about it.

References

American Diabetes Association Professional Practice Committee. (January 2022). Facilitating Behavior Change and Well-being to Improve Health Outcomes. Standards of Medical Care in Diabetes.

Polonsky, W. H. (2022). Emotional and quality-of-life aspects of diabetes management. Current diabetes reports.

De Groot, M. Anderson, R., Freeland, K.E., Clouse, R.E., and Lustman, P.J. (2001). Association of depression and diabetes complications: A meta-analysis. Psychosomatic Medicine.

Gonzalez, J.S., Peyrot, M., McCarl, L.A., Collins, E.M., Serpa, L., Mimiaga, M.J., and Safren, S.A. (2018). Depression and diabetes treatment non-adherence: a meta-analysis. Diabetes care.

Hendriks, S.M., Spijker, J., Licht, C.M. et al. (2014). Disability in Anxiety Disorders. Journal of Affective Disorders.

Young-Hyman D., de Groot M., Hill-Briggs F., Gonzalez J.S., Hood K., Peyrot M. (2016). Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care.

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