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Diabetes Distress

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By M. Kathleen Figaro, MD, MS, FACE

Many people with diabetes report feeling overwhelmed by diabetes and not wanting to deal with it. This is actually very common — so common that it has a name: diabetes distress. About 50 percent of people with diabetes have distress symptoms at one point in their diagnosis or another. Diabetes distress makes a person feel bad — mentally and emotionally — and can affect physical health.

Furthermore, hypoglycemia, low blood glucose that causes feelings of unwellness, is distressing and so may reduce your willingness to take insulin doses. Often, physicians who take care of diabetes may not even ask about hypoglycemia, and some patients may not want to provide that information in case they want to keep the patient from driving or other important activities because of low blood glucose.

I think the emotional distress commonly seen in patients with diabetes is not a traditional depressive disorder, even when there is an elevated score on a depression questionnaire or even recognizable depression symptoms. When distress is secondary to frustration about chronic hypoglycemia or fear of complications (i.e., diabetes-related distress), a patient will likely need different support and responses from their doctor.

Although antidepressants are less likely to be effective in most people with distress, physical activity, psychotherapy, and discussions with diabetes team members can be effective. I’m sure patients are relieved when a doctor initiates discussions about distress. Even brief conversations that label your feelings, link them to difficulties with self-management, and normalize emotional reactions to diabetes issues can be reassuring. Indeed, even talking and expressing emotional experiences of diabetes can be therapeutic.

Healthcare professionals can avoid stigmatizing patients by avoiding placing blame. I’m sure many also appreciate a doctor who avoids using stereotypes (about eating or exercise habits) so that they can engage more in patient health and help improve your diabetes-related distress. In general, good communication skills and more supportive language in clinical settings can help support wellbeing and optimize diabetes self-management.

Reaching out to a diabetes care team and other support systems, such as churches or other community groups about feelings lets them help patients get relief from distress. A comprehensive approach that knows the difference between clinical depression and disease-related distress can offer support for management of emotional distress. It can be an integral part of providing support for management of diabetes and will have the greatest likelihood of clinical benefit.

Come into Heartland Endocrine Group where we can help you to overcome your distress and help to give you the momentum to improve your diabetes control and take control of your health.

Be one of the first 20 people to bring a copy of this article to our office for a free 30 minute – one-on-one new patient appointment to discuss your diabetes and ways to overcome your diabetes distress.

Heartland Endocrine Group is located at 4620 E. 53rd Street, Davenport, IA 52807. For more information and to schedule an appointment, call our office at 563-424-6306 or visit us online at www.heartlandendocrinegroup.com.