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How stress can be another complication of your diabetes

By Laura A. Magnifico

The daily challenge of checking glucose levels, maintaining a nutritious diet, exercising and staying on top of medications can be exhausting and frustrating. Living with diabetes also causes emotional worry: You may wonder, “How am I going to manage my disease for the rest of my life?” “Will I develop any of the common complications of diabetes?”

“Unfortunately, people can get ‘burned out’ when they feel overwhelmed and often their diabetes self-care suffers,” explains Amber Taylor, MD, director of diabetes at the Center for Endocrinology at Mercy Medical Center in Baltimore. At least one study has shown that emotional distress that’s related to diabetes — for example, stress over your daily diabetes care — is also significantly linked to blood glucose control.

How do you know if you have diabetes distress?

In any 18-month period, between one third and one half of those with diabetes suffer from diabetes distress, says the American Diabetes Association. This condition still isn't well understood, but it's characterized by a feeling of significant burden associated with your diabetes management. To find out if you’re experiencing diabetes distress, your doctor will administer a screening test, which focuses on four areas:

• Schedule distress: Do you feel the burden of having to monitor and control your diabetes each day?
• Diabetes complications: Do you worry about the long-term effects of your diabetes and whether you may have future complications of the disease?
• Medical care: Are you concerned about whether or not you’re receiving the best treatment? Are you worried about the cost of care?
• Social concerns: Do you feel guilt or shame for having the disease?

What can you do about diabetes distress?

Feeling worried or uneasy, especially when you are first told you have diabetes, is understandable. And as you become more comfortable with managing your disease, you may even reach a point where you can confidently say, “No problem. I've got this figured out!” But somewhere between worry and nonchalance is a happy middle ground: “a delicate balance of ‘just enough’ worry [that] can bring [about] good things — reevaluating, motivating, planning and discipline — all destined to improve health,” says Wendy Satin Rapaport, PsyD, a clinical psychologist with more than 30 years’ experience working with people with diabetes. She urges those newly diagnosed and feeling overwhelmed to seek the assistance of a mental health professional who can help them cope with and manage the disease.

Another key to alleviating diabetes distress is to view your condition in a more positive light. For instance, Rapaport teaches her patients to think of diabetes as a challenge rather than a burden — a challenge they can handle. Other coping tips include:

• Reaching out for support. You’re not alone; there are others who are feeling and experiencing what you’re going through. You can find diabetes support communities online through MedHelp.
• Learning how to better manage your diabetes, one step at a time, so it’s not so overwhelming. “I work with patients to make small changes each visit, set goals and work towards hitting all the targets,” Taylor says. A blood sugar tracking app like Sugar Sense (for iPhone and Android) can help make daily diabetes management easier.
• Learning how to cope with stressful situations. Some ways to manage stress include: exercise and a healthy diet, which keep your body primed to handle adverse situations; staying in touch with friends and family for emotional support; and regular meditation and other relaxation techniques, such as deep breathing and guided imagery, which can help calm an anxious mind.

Be sure to consider whether your diabetes distress may have progressed to clinical depression (your doctor can help you evaluate your situation) and also to get the proper treatment if your stress seems chronic. Lowering your stress levels can help prevent fluctuations in blood sugar levels, as well as keep you in better emotional and physical health.

Published on March 15, 2015. Updated on April 28, 2016.

Laura A. Magnifico is a freelance writer living in Stamford, CT.