email     Drsoohoo@sequoiacounselingoc.com                                                   
phone     949.337.1034                 
mailing address   340 E. 1st St. #291, Tustin, CA 92781         
Sequoia Counseling & Wellness Services OC offers virtual teletherapy services for California Residents  

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? 
  • Complex and demanding treatments   
  • Following guidelines doesn't guarantee positive results
  • Often little immediate positive feedback
  • No disease "vacations" resulting in feeling burned out 
  • Cultural and health beliefs may clash with self management practices
  • Environment discourages healthy lifestyle practices
​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
       practices:                       
       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 is 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 mood. 

     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-
       management goals.

     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
​Address Common Concerns: 

Healthy Eating: 
The American Diabetes Association made this video to address their #1 question, "what can I eat?": 
Another curious topic, exercise vs nutrition for health and diabetes care, is addressed in the following article from Diabetes Daily. Of course, it is essential to discuss any behavior changes related to medication, food choices, and physical activity with your health care team first. The best lifestyle changes are the ones that you are able to apply most consistently! 
Communicating With Others about Diabetes and Its Care: 
   Relationships can be a key area of stress for persons living with diabetes. Casual interactions with strangers or conversations with loved ones about your diabetes can have an impact on your emotions and behaviors. Consider these supportive articles:
Sleep Quality: 
   Is it hard for you to get a good night's sleep on most nights? This is not uncommon, considering that diabetes can affect sleep duration and quality and vice versa. Additionally, sleep duration and quality can be impacted by lifestyle behaviors. Here are some basic tips to support a good night's sleep: 
Physical Activity - Get Moving! :
  Physical activity is an important component of diabetes self-management. Exercises can vary in intensity and can be performed by anyone. Consult with your diabetes health care provider regarding which exercises are best for you. There are two ways to improve physical activity levels: 1) active exercise- click here to read more on how it affects blood glucose levels; 2) less time sitting. Yes- the effects of too much time spent sitting is now likened to smoking as a health risk behavior. This American Diabetes Association infographic can give you some ideas for how to promote exercise as a lifestyle in your home or workplace: 
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