Did you know that 29% of Canadians live with diabetes or prediabetes every day? Even though the chronic condition is manageable with the right medication and diet, it still disrupts everyday life. Between insulin shots and managing sugar levels, it’s easy to forget about the mental health aspect of living with diabetes. 

There is a connection between diabetes and mental health. Mental health professionals have researched a condition known as “diabetes distress” which highlights the various emotions and the burden of living with diabetes. 

Yet knowledge is power and there’s value in knowing the connection between diabetes and mental health. When you’re able to identify the mental health issues associated with diabetes, then it becomes easier to manage. 

Let’s explore the relationship between diabetes and mental health, as well as the various treatment and therapy options available. 

What is the relation between diabetes and mental health?

Most people are familiar with the physical health risks of diabetes. For example, people with diabetes are over three times more likely to be hospitalised with cardiovascular disease. Other risk factors for diabetes complications include being 20 times more likely to be hospitalised for non-traumatic lower limb amputation. 

However, diabetes complications also include serious psychological distress and both type 1 and type 2 diabetes can trigger mental disorders. 

There are several ways that diabetes impacts mental health;

• Diet restrictions can be a challenge
• Tracking blood glucose and insulin can be disruptive
• Managing diabetes can be a financial burden
• Changes to daily life can be emotionally draining
• Blood sugar fluctuations can be stressful and cause mood changes when blood sugar levels drop
• Fear of hypoglycemia can cause significant worry

A combination of these factors contributes to an estimated 33% to 50% of people with diabetes experiencing a form of diabetes distress.

How to identify mental health problems in people with diabetes

It’s easy to overlook the signs and symptoms of diabetes-related mental health problems, which only adds to the stress. In fact, up to 45% of mental health conditions, including severe psychological distress, go unnoticed among those being treated for diabetes.

Whether you or a loved one live with diabetes, it’s important to identify the risk of mental health conditions for people with diabetes. One of the most effective ways is being regularly screened for mental health conditions during treatment visits. 

A proper diagnosis by a medical professional will be able to identify the signs and symptoms associated with a blood sugar level that is too low or high and impacting mental health. Mental health screenings should be integrated with the treatment plan to identify common psychiatric disorders and help improve quality of life. 

What is the link between diabetes and depression?

The mind and the body are intricately connected, and mental health issues that are left untreated can make diabetes worse. In the same breath, living with diabetes can trigger mental health problems. Depressive disorders are one of the most common mental health struggles of a person living with diabetes.

Research shows that people with diabetes are up to three times more likely to live with depression than the general population without diabetes. However, only 25% to 50% of diabetic people with clinical depression get treated. 

You may be familiar with the signs and symptoms of diabetes, but there are also a few symptoms that could indicate depression;

• Feeling sad or empty 
• Loss of interest in former passions
• Change in appetite (either excess eating or no eating)
• Unusual sleeping patterns (either too much sleeping or struggling to sleep)
• Difficulty to concentrate or make decisions
• Constant exhaustion
• Feelings of hopelessness, irritability, anxiety or guilt
• Experiencing aches, pains, headaches, cramps or digestive problems
• Thoughts of suicide or death

Stress and anxiety

Stress is a normal part of life, and diabetes can add to the stress. In many instances, stress manifests as emotional reactions such as fear or anger. However, it can also appear in physical ways such as sweating and increased heart rate. 

Stress hormones can also affect blood sugar levels, causing them to rise and fall without warning. Experiencing stress over a long period of time can worsen existing health issues. Cognitive behavioural therapy and small lifestyle changes can help to alleviate the effects of stress and anxiety. For example, getting active, doing meditative exercise and limiting alcohol and caffeine.

Diabetes distress

Self-managing diabetes on a daily basis can be stressful. While some days are more challenging than others, the responsibility of managing diabetes doesn’t stop. 

The burden of self-management, as well as the stress for long-term complications, can be a lot to process. Dealing with the social implications of stigma and the lack of understanding, as well as the financial burden, adds to the chance of diabetes distress.

To put it into perspective, approximately one in five people experience severe diabetes distress. When people are first diagnosed with diabetes, the shift in lifestyle can be overwhelming. 

The best way to manage diabetes distress is within the context of diabetes care.

Feeding and eating disorders

Managing diabetes involves a shift in diet, which can sometimes lead to further complications with food. Various factors play a role in a diabetic’s relationship with food and can trigger an eating disorder.

• Dietary changes
• Frequent monitoring of blood glucose
• Increased control over meals
• Weight gain caused by taking insulin

Depending on the individual, eating disorders can appear in various ways. For example, diabulimia is a risk among adolescents with type 1 diabetes, when the person stops taking their insulin in an effort to lose weight. 

Another eating disorder is night eating syndrome which is more common among people with type 2 diabetes, especially those with the symptoms of depression. The side effects include weight gain, poor glycemic control and further diabetes complications.

Treatment and therapies

Diabetes is treated and managed through the likes of insulin injections, monitoring sugar levels, and adapting your lifestyle. In the same way, mental health issues related to diabetes are treatable with therapy and medication.  

Depending on whether you’re experiencing anxiety disorders, diabetes distress, or eating disorders, there are different treatment options. 

Therapy

There are various options for therapy, best suited to different people and their preferred method. Consider the following as a starting point;

• Cognitive behavioural therapy (CBT) - focusing on the cognitive role of taking healthier actions and changing beliefs, thereby managing certain conditions
• Family therapy - prioritises the role that family plays in treating various conditions, with a focus on communication and learning to manage conflict
• Dialectical behavioural therapy (DBT) - focusing in four main areas namely mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness

Medication

Diabetes medications have become increasingly more available, especially with the likes of Mednow which offers a fully accredited full service pharmacy, personal online care and free delivery. The good news is that mental health medication is also easily accessible. 

The first step when deciding on a mental health treatment is to talk to a mental health care provider. Various medications have even been linked to helping control a type 2 diabetic’s blood pressure. However, it’s important to consult a medical professional as other side effects could increase the chances of developing diabetes (due to the side effect of weight gain). 

Stress management

Stress can have a direct impact on a person’s blood sugar levels, making it very difficult to manage diabetes. An effective way to help manage stress involves self-awareness and recognizing the stressful triggers. 

Working with a professional can help determine these triggers and teach relaxation and coping techniques to lower stress. 

Talk to your health care professional

You’re not alone in your journey of managing diabetes. Talk with a healthcare professional if you notice the warning signs of diabetes distress and other mental health conditions, and ask your treatment team to do a mental health screening with each consultation. 

 

If medication is prescribed to help manage your mental health, then Canada’s online pharmacy is here to help, offering personal pharmacist attention at every step. With free delivery as well, stress is kept to a minimum. Get started with Mednow today!

This article offers general information only and is not intended as medical or other professional advice. A healthcare provider should be consulted regarding your specific situation. While the information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgement of the authors as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by Mednow or its affiliates.

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