Dealing With Diabetes Distress
People with diabetes have to think about their condition and make treatment decisions constantly — and all that extra work and worry can lead to psychological distress at times.
“Diabetes distress” isn’t the same as depression, however, diabetes experts note. It’s a condition unique to the 24/7 demands that come with diabetes, particularly for people dependent on insulin.
“The day you develop diabetes, it’s like the universe just handed you a new full-time job that you have to do in addition to whatever else you’re doing. It’s a special job that has a big impact on the rest of your life. There’s no pay and no vacation,” said William Polonsky, president of the Behavioral Diabetes Institute in San Diego.
Alicia McAuliffe-Fogarty, vice president of lifestyle management at the American Diabetes Association, put it this way: “Diabetes distress is the extra burden that people with diabetes have to carry. They have to do everything that other people do — take care of work, family, finances — and in addition they have to make sure to check their blood sugar, remember to take their medicine and/or adjust their insulin doses, count carbohydrates when they eat.
“It’s a day-to-day and minute-to-minute burden. It’s doing everything ‘right’ and still seeing your blood sugar levels go up,” she added.
Diabetes distress is a range of different emotional responses that come with dealing with the burdens of caring for diabetes, Polonsky explained.
“It’s being fed up and overwhelmed with the demands and concerns of diabetes. It’s feeling powerless in the face of diabetes. It’s knowing that despite your best actions, sometimes those [insulin] numbers go up and down and it seems beyond your ability to influence. And it can negatively influence one’s quality of life,” he added.
The phenomenon hasn’t been well-studied — Polonsky said he and his colleagues are in the middle of a study on diabetes distress that will hopefully answer some questions about the condition.
He said diabetes distress probably affects about 30 percent of people with diabetes at some point in their lives.
“It’s not everybody, and it’s not all the time, but it’s pretty darn common, and a whole lot more common than depression” among those with diabetes, Polonsky added.
Diabetes distress and other psychological conditions are common enough that the American Diabetes Association added a section to its Standards of Medical Care in Diabetes – 2017 guidelines on screening and treating people with diabetes for distress, depression and other mental health concerns.
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