Diabetes Related Distress

Diabetes can be an overwhelming disease to manage.  To keep the disease in control in order to reduce health complications, there is the balancing act of what to eat, how much to eat, the amount of carbohydrates to take in without becoming hyper-or-hypoglycemic, getting in exercise, taking medications, checking blood sugar levels throughout the day and if needing to use insulin, when to take it and how much to take.

It’s a never-ending cycle of remembering all of the above and keeping oneself motivated to make sure it all happens each day.  This can lead to a term called diabetes-related distress.  It is not the same thing as depression but is very common among people with diabetes including their family members. 

Diabetes is a serious, long-term condition that often stirs up feelings of frustration, worry and burnout.  Diabetes requires a lot of hands-on management and for many, this leads to stress and feelings of “I can’t do all of this” particularly if their diabetes numbers are higher than they should be. The stress of dealing with diabetes daily can also be centered on fears of the future, concerns with complications, keeping up with new medications, and dealing with family and friends who may not be very supportive. 

The stress of life affects each one of us but for someone with diabetes it can have an impact on blood sugar control.  Stress, particularly if it is severe and ongoing, makes our body get ready to take action called the fight-or-flight response.  The cells of the body need sugar for energy to fight or run away.  But in people with diabetes, insulin may not be available to let this extra sugar into the cells so this can elevate blood sugar levels. 

Fortunately, there are steps one can take to relieve diabetes-related distress.  Yes, diabetes is a disease to deal with long term but remember there are many with the condition leading and living their life to the fullest.  It can be done when one looks at it from the perspective of having a disease that you are in control of and not vice versa.  Keep the following recommendations in mind to keep diabetes-related distress more manageable:

·         Take changes one at a time

Meeting with a doctor for the first time after your diagnosis and being told all the things you will need to change (diet, exercise, taking medications, etc.) is overwhelming.  Trying to tackle them all at once may backfire.  Sometimes the more we take on, the greater the probability none of them will be accomplished.  This can lead to feelings of frustration and failure. 

The solution is to talk with your healthcare team to decide which one will be easiest for you to handle first.  Create a list of priorities for change and then deal with each one separately before moving on to the next one.  This can result in less frustration while increasing feelings of being in better control and which can lead to better compliance.

·         Accept the fact you can’t control everything

One of the more frustrating things for someone with diabetes is when they are doing everything they can to keep their blood glucose under control, and yet it may not be within the normal range where it should be at times.  Sometimes, there are no easy answers for this.  The best bet is to continue to do the best you can by closely following your meal and exercise plan, taking any medications and engaging in activities to relieve stress.  Go easy on yourself and know that life is not perfect and neither is diabetes management.

·         Get support from people who can relate

Family and friends can give good support but some of the best support comes from others who have diabetes.  They know firsthand what you are going through. Talking with others can help a person gain perspective. They may be able to identify specific aspects of self-management that need to be worked on and then make plans on how to correct it.

Some people with diabetes find diabetes support groups to be extremely helpful.  They may not be for everyone, but sometimes talking with others who understand diabetes and are willing to listen can help you realize you are not alone in your feelings of frustration.  Just being able to talk about your feelings is often more helpful than always finding a supposed solution.

·         Learn to relax

There are many ways in which one can learn to relax when stress becomes overbearing.  Getting in some physical activity is a good one to start with.  Moving your body by walking, stretching, or riding a bicycle are all excellent ways to relieve stress while burning calories, improving circulation and clearing your mind.

Learning to take a deep breath or practicing breathing exercises is another proven way to help ease the feelings of stress.  When stressed out, take a break by sitting or lying down.  Breathe in deeply and then push out as much air as you can.  Continue this type of breathing for several minutes focusing on relaxing all the muscles in your body.

Imagery exercises have incredible power to help reduce stress and deepen relaxation.  Sitting in a comfortable position, relax with some deep, abdominal breathing.  Envision an imaginary scenario of where you focus on imagined sights, sounds, smells, and tastes.  Create a scenario of images leading to peacefulness, joy and a sense of well-being.  Once done, your body will feel less stress and fatigue leaving you feeling more relaxed and rejuvenated.