Navigating a Diabetes Diagnosis: How to Manage Mental and Physical Health

Leslie S. Arceneaux, faculty member within the Georgetown University School of Nursing, was working at a clinic for diabetes treatment when she noticed a patient’s blood sugar had suddenly spiked since her previous visit. After asking the patient some questions about her day-to-day life, Arceneaux identified the cause: stress. The patient said her husband usually helped administer her insulin, as she had a fear of needles; however, his work schedule changed, leaving her to manage her own treatment. Arceneaux solved the issue by identifying an auto-injector device that the patient could use more comfortably. 

While it is important for nurse practitioners to advise patients with diabetes on elements of treatment such as medication, diet, and exercise, emotional and mental health are also important factors that can affect patient outcomes. That is why Arceneaux and other health care professionals in her field aim to provide comprehensive care at the point of diagnosis, acknowledging both the mental and physical health of their patients. 

As with many chronic conditions, receiving a diabetes diagnosis can evoke an emotional response from patients. 

“Some of the feelings that go along with bereavement include disbelief, denial, anger, frustration, hopelessness, and fear,” Arceneaux said. Individuals with type 2 diabetes may also feel guilt or shame, internalizing blame for not taking care of their health.

Children and adolescents, who are most often diagnosed with type 1 diabetes, may experience additional emotions when learning about their diagnosis, such as isolation and embarrassment as a result of feeling different from their peers, according to an article in DiabetesSpectrum on psychosocial challenges among children with diabetes.

Arceneaux said it is also common for parents of children with diabetes to experience stress or fear upon receiving a diagnosis. 

For this reason, it is important for patients and their family members to process their feelings, as individuals with diabetes may deal with mental and physical health challenges throughout their lives. 

“It is a very comprehensive disease, and the emotional side of it never goes away,” Arceneaux said. 

Patients diagnosed with diabetes may experience “diabetes distress,” a term used to specifically describe an emotional response to living with diabetes that can lead to poor self-care. Diabetes distress differs from depression because it is not considered a mental illness, but the two can be interlinked.

According to Arceneaux, symptoms of depression and diabetes distress can include the following: 

Individuals with diabetes can address emotions they are feeling by doing the following: 

Understanding your condition, establishing a support system, and finding ways to address your concerns can help to manage the emotional challenges associated with a diabetes diagnosis. 

“The key is reassurance, support, and education,” Arceneaux said. 

There are many ways in which mental and physical health are connected. For example, according to the National Institute of Diabetes and Digestive and Kidney Diseases, people with diabetes are more likely than the general population to have depression, a comorbidity that is tied to poorer health outcomes. 

Additionally, Arceneaux noted that chronic stress can cause an individual’s body to develop more cortisol, which can affect blood sugar, blood pressure, and other factors that can be detrimental to managing diabetes.  

By understanding these connections, individuals can better manage their diabetes and their emotional well-being. 

Tips for Adolescents and Adults 

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Adolescents

FEELING A SENSE OF SOCIAL ISOLATION 

Emotional challenge: Having a chronic condition at a young age can lead to feeling embarrassed about being different from peers.

Physical challenge: Adolescents who are old enough to manage parts of their care, such as administering insulin, may avoid adhering to their care plan, which can cause health complications.

How to address it: Parents can talk with their child about the importance of managing their condition and monitor behavior without taking away a sense of independence and agency. 

Adults

EXPERIENCING DEPRESSION OR “DIABETES DISTRESS” 

Emotional challenge: Feeling depressed or burned-out can make it more challenging to achieve daily tasks. 

Physical challenge: Poor self-care can affect medication adherence, which can negatively affect an individual’s ability to manage their diabetes

How to address it: Patients can ask their providers for help seeking mental health care and discuss the potential for adjusting their care plan to make it easier to manage. 

All Ages

ADAPTING TO CHANGE AFTER RECEIVING A DIAGNOSIS 

Emotional challenge: A big life change can cause individuals to feel overwhelmed, leading to ongoing stress.   

Physical challenge: Chronic stress can affect blood sugar levels, blood pressure, and other factors that affect the progression of diabetes. 

How to address it: Patients can work with providers to make incremental changes in a personalized care plan so it is more manageable and less stressful. 

NAVIGATING SOCIAL EVENTS 

Emotional challenge: Having dietary restrictions may lead to a fear of missing out on food at events.

Physical challenge: Monitoring levels and making adjustments for food intake is important for managing diabetes.

How to address it: Moderation is okay. Providers can offer guidance on how to balance diet and adjust medical treatments. 

Be a good listener. Let the loved one share their feelings without interruption and on their terms. 

Give reminders. Help them adhere to their care plan by reminding them about their medication regimen or help facilitate care if the person needs it. 

Share a meal. Join the friend or family member in eating food that caters to their health needs. 

Get moving. Participate in physical activities with the loved one, such as going for a walk.

Stay involved. Attend appointments and support them in advocating for their care by asking questions. 

Model behavior. Children with diabetes can benefit from seeing their parents and siblings limiting sugary snacks, engaging in physical activity, and implementing other healthy behaviors. 

 Citation for this content: Nursing@Georgetown, the online MSN program from the Georgetown University School of Nursing