Diabetes can be a difficult and demanding chronic disease requiring relentless self-management. The regular tasks required to control diabetes including monitoring blood glucose levels, eating healthy meals at regular times, watching for symptoms of serious complications and more, can lead to overwhelming feelings of frustration, exhaustion and defeat. These constant demands over time can cause what experts call diabetes distress—or the difficult emotional response to living with and managing diabetes. Left untreated, this distress can cause you to slip into unhealthy habits and lead to poor health outcomes. If you think you may be experiencing significant stress that is negatively impacting how you manage your diabetes, here’s what to watch out for and some positive steps you can take.

Symptoms of Diabetes Distress

If you feel like diabetes is constantly weighing on you and you wish you could take a break from the disease, you may be struggling with diabetes distress. The Diabetes Distress Scale can be a helpful tool to identify whether your level of distress is concerning. Specific feelings and symptoms to watch out for, include:

• Feeling angry about your diabetes
• Lacking the motivation to make lifestyle changes or maintain healthy choices
• Avoiding doctors’ appointments
• Making poor food choices regularly
• Not checking blood sugars
• Feeling isolated and alone

These symptoms can fluctuate over time and may get worse during the more challenging periods of your disease. This can occur immediately after diagnosis, following changes to your treatment plan or after a diabetes-related complication.

Diabetes Distress vs. Diabetes-Related Depression

Clinical depression is a general loss of interest in all parts of life, while diabetes distress is more of an indifference or apathy towards your diabetes and self-care. A proper diagnosis is important because the treatment options are different and diabetes distress is unlikely to respond to medication. Symptoms of clinical depression may include:

• Feelings of sadness and hopelessness
• Sleeping too much or not enough
• Unintended weight loss or gain
• Unexplained physical pain like headaches or stomach aches
• Loss of interest in typical activities

Reach out to your doctor if you have been experiencing the signs of depression for more than two weeks. If you are having any thoughts of hurting yourself, call 911, go to the nearest emergency room or call Talk Suicide Canada at 1-833-456-4566 now.

Tips for Managing Diabetes Distress

Everyone living with diabetes will feel frustrated, stressed or overwhelmed by their disease at times. But if you experience these feelings consistently, or regularly, you may need extra help to start to feel better. Here are some things you can do:

1. Be Kind to Yourself: The best first step is to stop blaming yourself—diabetes management is hard. It can be particularly frustrating when your glucose numbers change every day, even after doing the same thing from one day to the next. Do your best, celebrate the wins and avoid focusing on factors that are out of your control. Perfectionism around your diabetes care will inevitably lead to burnout and stress. It can also be helpful to remove ‘good’ or ‘bad’ blood sugar from your vocabulary and replace these terms with ‘high’ or ‘low’.
2. Take It One Day at a Time: Make a list of priorities or the things that you want to change and start addressing each one separately. To simplify your care, set realistic goals like, ‘walk twenty minutes every day’. After you’ve made and maintained that change, add another small goal or increase your goals to keep you motivated and confident. Your diabetes care team can also help you set and reach these goals.
3. Do More of What You Enjoy: There’s no denying that managing diabetes is a lot of work, but making time for activities that combat stress and bring you joy is key to supporting your mental health. Call a friend, take a bath, book a massage, go to an exercise class, or do whatever else relaxes you. If you’re feeling distressed, and your usual coping techniques aren’t working, ask your doctor for other ideas.
4. Talk to Your Health Team: At your next appointment, let your diabetes care team know what you’ve been experiencing. They can refer you to another health professional who can help you deal with your distress and direct you to additional support and resources. This can include further diabetes education to better manage the physical symptoms or a referral to a mental health professional who specializes in chronic health conditions.
5. Reach Out: Diabetes distress can also be felt by the loved ones of people living with diabetes. Tell your spouse, family member or friend about your distress levels and check in to see how they are feeling. Be direct about what would make things easier and how they can help. They may remind you to take your medicine, go with you to medical appointments, join you in being more physically active, make more healthy meals together or just be there to listen and vent with. Connecting with other people living with diabetes through online or in-person support groups can also help you feel less alone or overwhelmed.

Diabetes care isn’t easy and takes a lot of hard work, diligence and patience. The next time you feel stressed or burned out by your diabetes, stop and acknowledge that it’s totally normal to feel this way. Accept that there will be some level of distress when you are living with a chronic illness, but take action to make sure that it stays manageable. This could be by reviewing your diabetes skills, reaching out to the right people for support or prioritizing self-care. If your distress continues, connect with your diabetes healthcare team again for more helpful resources.

For further support, please see the information and resources VHA Home HealthCare has put together for those managing chronic diseases at https://www.vha.ca/services/cdsm/.