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 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
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
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