Diabetes and Psychological/Behavioral Health Support
1 in 10 Americans currently lives with diabetes.
1 in 3 Americans are pre-diabetic. (National Diabetes Statistics Report - CDC, 2020).
Diabetes is the seventh leading cause of death in the United States.
Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. It can be a complete life change! While there is no cure for diabetes, progression can be slowed by losing weight, eating healthy food, and being active. Taking medicine as needed, monitoring blood glucose levels, and keeping health care appointments can also reduce the impact of diabetes on your life. If diabetes is not managed well, it can lead to heart disease, vision loss, kidney disease, or other serious health complications.
Diabetes Care Can Be Time Consuming !
Persons with diabetes will spend on average 15-60 minutes per year talking with their physician about their diabetes... and about 60-120 minutes per day participating in self management behaviors ! Self management tasks may include glucose monitoring, taking pills and/or insulin, attention to dietary intake, attention to physical activity, regular health care visits & screenings, and stress management.
The Responsibility of Diabetes Management Largely Falls on the Shoulders of the Person With Diabetes .. Consider the Following Ways Self-Management Can be Difficult... Can You Relate?
Ways That Therapy Can Improve Your Diabetes Care
Most therapy treatment goals will involve communication with your diabetes care team, especially your primary care provider/endocrinologist/nephrologist. Here are specific concerns that can be a focus of evaluation and treatment for persons living with diabetes:
1) Adjustment to changes in health status and self-management
Stress and mood changes are common occurrences in response to diabetes diagnosis and progression. Adjustment challenges can come and go as life circumstances and
activities impact diabetes self-management. Worry,
self-blame and shame, hopelessness, denial, and worries that
something bad could happen are common experiences.
Another adjustment response, Diabetes Related Distress,
refers to burnout that may result from having diabetes and
managing it. Diabetes related distress can have an impact on
your emotional, physical, and behavioral responses. Therapy
can help to clarify how burnout or diabetes related distress
is impacting you, and take steps to treat it.
2) Depression: Negative feelings, such as depression or grief, can
produce stress hormones which can cause your blood glucose
levels to rise. Depressed or sad feelings can also affect your
motivation and energy to take care of your diabetes.
Awareness of depression symptoms is important for persons
with diabetes; 18%–25% of people with Type 2 Diabetes will be
diagnosed with a Major Depressive Episode, a prevalence
that is at least double that of the general population.
Cognitive Behavioral Therapy has been shown to be effective
for the treatment of depression in persons with diabetes and
also to support glycemic control.
3) Grief: Grief can be a common emotion as you are accepting the
implications of having diabetes and living with it. When grief
is strong and long lasting, it can progress into a depressed
4) Stress due to having diabetes and/or everyday life: Learning
and applying stress management skills can help you better
manage your blood glucose levels and behavior choices.
Ignoring stress or pretending it does not exist does not
help. When you are under physical or emotional stress, your
blood glucose levels tend to rise. It may also be harder to
follow healthy lifestyle practices with higher amounts of
stress. Therapy can help you understand the connection
between your stress and how it affects your diabetes control.
It can also provide you with strategies and support to
handle stress better and continue to achieve your self-
5) Sleep Quality: Sleep disorders are more common among people
with diabetes than within the general population. Insufficient
sleep can affect insulin levels/glucose control and influence
daytime food cravings for sugars and carbohydrates. The
American Diabetes Association specifically recommends
assessment of sleep pattern and duration due to the
relationship between sleep quality and glycemic control.
Therapy provides personal attention to identifying barriers to
getting a good night's sleep and providing skills and support to
improve sleep quality.
6) Other factors that may cause you to feel "off": High glucose
levels can cause symptoms that look like depression. During the
day, high or low blood glucose levels can cause you to feel tired
or anxious. Low blood glucose levels can also lead to hunger and
eating too much. If you have low blood glucose at night, it could
disturb your sleep. You may get up often to use the restroom
and then feel tired during the day (information from
American Diabetes Association). These are examples of how
complex diabetes management can be and illustrate why
experts recommend a comprehensive treatment approach that
addresses depression and diabetes together.
Educational Resources and Inspiration to
I can partner with you, your medical team, and family to help you adjust to your diagnosis, follow treatment recommendations, lessen diabetes-related family conflicts, cope with life transition, or treat any depression or anxiety symptoms you are currently experiencing. I am committed to your health and diabetes control! If you would like to have me as your ally in health, call or write today!
- Dr. Melissa Soo Hoo