Dealing with diabetes puts a lot of attention on blood glucose monitoring, insulin and medications, which are important, of course. But there is an emotional side to diabetes that should be addressed, too. As May is Mental Health Awareness Month, I am focusing on Diabetes and Mental Health.

The complications of uncontrolled diabetes are well recognised: nerve damage, kidney disease, blindness, and

circulation problems that affect the extremities. The disease’s impact on the brain, however, is often overlooked. This oversight could spell trouble for persons who face the daily challenge of controlling their blood sugar.

A growing body of evidence suggests that the cognitive health of millions with the disease is as much at risk, as are other body systems from the effects of out-of-control blood sugar. The long term stress and strain of diabetes management can lead to a decreased quality of life, and an increased likelihood of depression. A study into whether impaired glucose metabolism can explain the increased prevalence of depression in people with type 1 diabetes is quite instructive. It appears that chronic hyperglycemia, and insulin resistance, (the hallmarks of diabetes), trigger the release of these adhesion molecules, which set off a cascade of events that lead to the development of chronic inflammation. Once chronic inflammation sets in, blood vessels constrict, blood flow is reduced, and brain tissue is damaged. Some scientists have begun calling Alzheimer’s disease “type 3 diabetes”, due to its characteristic complications of profound memory loss, and severe cognitive decline.

Diabetes:

• interrupts your workday when you have to check your blood glucose.
• means you can’t just grab food whenever you want; you have to plan for it.
• prolongs getting ready in the morning, as you wash and inspect your feet.
• increases your budget.
• frustrates you when your taste buds cry out for a pastry, instead of an apple.
• makes you worry about your future. All of the time, effort, money, and stress interrupt your emotional stability, while introducing emotional complications; and it’s okay to be frustrated, overwhelmed, or scared.

Diabetes and ‘Being in Control’

Let’s face it – Most of us like being in control… we don’t like feeling that anything is out of our control! When it comes to diabetes, you can simultaneously feel in, and out of control.

Out of control – Because of how diabetes affects your body, it is possible to feel that nothing is in your control anymore. You can’t eat what you want, when you want. You have to take medications, or give yourself injections. You can start, perhaps, to feel that your body isn’t yours anymore.

Counteracting that ‘out of control’ feeling – Taking a step back and looking objectively at the situation may help. You can say to yourself, ‘yes, diabetes makes me do these things, but diabetes does not run my life’. Also, you can do a mental mind shift; ‘all these steps I’m taking to manage my diabetes are actually proactive, healthy steps’. You are taking control of your condition and life as you learn how to thrive with diabetes.

In control – One of the main things your doctor checks at appointments, is your blood glucose control; so yes, control is a big deal in diabetes. However, it’s possible to become too focused on (and therefore stressed about) that level of control. You can start to feel if you don’t do everything perfectly every day, then you will damage yourself.

Counteracting that ‘too much control’ feeling – Similar to the ‘out of control’ feeling, it’s helpful to take a step back. Realise that you are doing the best you can in managing your diabetes. Release the expectation to do it perfectly. If you are following your doctor’s instructions, you are doing well and being healthy; remember that and remind yourself of it when you start to stress about ‘doing more’.

Diabetes and Depression

Even with the knowledge that you have some control over diabetes, you will still be emotionally vulnerable to frustration, anger, and discouragement; and that’s understandable. You may even become depressed. If you think that you may be depressed, confront it.  Studies have shown that people who battle depression and diabetes together, tend to suffer more from diabetic complications. Talk to your doctor if you’re concerned about depression, as counselling and/or antidepressant medication may help.

Fortunately, most people who experience depression succeed at overcoming it. Moreover, people living with type 2 diabetes actually improved their blood glucose control after battling depression, by taking antidepressants.

Really, emotions are a normal part of life, just as diabetes is now a part of your life. If you address the emotions swirling around diabetes as they come up, you will be taking a healthy step toward better managing your type 1 or  2 diabetes.

Your feet mirror your general health . . . cherish them!