Diabetes & Mental Health- Is there a Connection?

By: Hourig Attarian, LWDI Intern

Diabetes is a disease that affects over 30 million Americans and is no walk in the park.1 Affecting almost every age group diabetes can consume the thoughts of the people it burdens. Imagine waking up one day not feeling too good, maybe even going to the ER and then you get the diagnosis, you are now diagnosed with diabetes! This changes everything and you feel like your entire life has been changed. Your relationships, your diet, your health everything is a little different now and it causes some anxiety, depression and may even worsen the symptoms of your diabetes. There even is a term for this negative feeling and it is called “diabetes distress”. 2 However, with proper lifestyle changes, education and support groups there is a solution and diabetes patients do not have to suffer alone.

https://www.diabetes.ca

What is diabetes distress?

There is no denying that the scene described above seems overwhelming, confusing and anxiety inducing. According to the CDC Diabetes Distress is a term that describes the overwhelming feeling persons with diabetes have when trying to manage their condition. When one has Diabetes Distress they can begin to have feelings of hopelessness, loss of control and they may even stop caring for their diabetes full stop. They will disregard their diet, stop checking their blood sugar and even skip out on important doctor’s appointments. All of these things can worsen the symptoms of diabetes which in turn causes even more distress and the cycle can feel endless.2

https://www.npjournal.org/article/S1555-4155(19)30491-X/fulltext

Is there a treatment?

The treatment for Diabetes Distress is for patients to become educated on diabetes by a healthcare provider they trust, get therapy from a therapist who is specialized in treating chronic health conditions, and joining support groups.2  Social media can also be a very helpful tool especially for young people. In one study the researchers found that young people aged 18-30 were using social media to gain a better understanding of their diabetes self-management by consuming content that was specifically tailored to them. The young people stated they felt more supported by creating relationships with others online who were going through similar experiences and could relate to them on daily life activities.3

Diabetes and depression

There is definitely a correlation between diabetes and depression. Some things may put a person more at risk for developing depression. These things might be gender; females are more at risk, being low income, having stressful life events happening, and having a lack of social support. The treatment for depression for people with diabetes could be pharmaceutical with antidepressants or non-pharmaceutical with lifestyle changes. One study took 50 patients with moderate levels of depression and put them through 12 weeks of cognitive behavioural therapy (CBT) for 10 sessions and combined that with 150 minutes of aerobic exercises a week. The study showed a significant improvement in the patients’ depression with most only having mild depression within 3 months of the trial. 4 The treatment of depression should be discussed between the healthcare provider and the patient to create the best plan to improve the quality of life. 

Stop the stigma!

As if living with diabetes is not stressful enough there has been research done that shows how much stigma diabetic patients have to deal with on a daily basis. One article surveyed a diverse group of persons with diabetes and found that the stigma was higher for patients who were overweight or obese, had poor blood glucose control and had higher insulin therapy needs. 5 The public would specifically judge type 1 persons with diabetes for having to openly check their blood sugar levels and monitor their insulin pumps. Whereas, persons with type 2 diabetes were being stigmatized for overeating, “lazyness” and being overweight or obese. The author of this article stated that the best way to stop the stigma associated with diabetes is to educate the public on the different causes of diabetes. It is important for people to understand that the patient is not solely responsible for having diabetes it also could be genetic and environmental issues.5 Stopping the stigma will allow people with diabetes to live more freely and openly without fear of being stigmatized due to their medical condition.

Looking forward in the future

The most important takeaway from this blog is the importance of prevention, diagnosis and treatment of mental health issues in persons with diabetes. It is critical that healthcare providers acknowledge their patients mental health as being part of the bigger picture in heath maintenance. We must not let depression and other mental health issues become underdiagnosed.6 With the proper treatment plan and support group, diabetic patients can beat mental health issues and live the best quality of life they can!

References:

  1. Statistics About Diabetes | ADA. Diabetes.org. https://www.diabetes.org/resources/statistics/statistics-about-diabetes. Published 2020. Accessed November 1, 2020.
  2. Diabetes and Mental Health. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/mental-health.html. Published 2020. Accessed November 1, 2020.
  3. Fergie G, Hilton S, Hunt K. Young adults’ experiences of seeking online information about diabetes and mental health in the age of social media. Health Expectations. 2015;19(6):1324-1335. doi:10.1111/hex.12430
  4. Robinson D, Coons M, Haensel H, Vallis M, Yale J. Diabetes and Mental Health. Can J Diabetes. 2018;42:S130-S141. doi:10.1016/j.jcjd.2017.10.031
  5. Liu NF, Brown AS, Folias AE, et al. Stigma in People With Type 1 or Type 2 Diabetes [published correction appears in Clin Diabetes. 2017 Oct;35(4):262. Folias AE [added]]. Clin Diabetes. 2017;35(1):27-34. doi:10.2337/cd16-0020
  6. Alajmani D, Alkaabi A, Alhosani M et al. Prevalence of Undiagnosed Depression in Patients With Type 2 Diabetes. Front Endocrinol (Lausanne). 2019;10. doi:10.3389/fendo.2019.00259

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