Type 2 Diabetes Mental Health: Understanding the Impact

Diabetes doesn’t just impact your physical health; it can have a direct effect on your emotional well-being1. “Diabetes distress” affects about 1 in 3 people living with type 2 diabetes2.

 

Table of Contents

Diabetes Distress Arrow icon
Diabetes and Anxiety Arrow icon
Diabetes and Depression Arrow icon
Managing Mental Health Arrow icon
Resources Arrow icon

Diabetes Distress

Diabetes doesn’t just impact your physical health; it can have a direct effect on your emotional well-being1. “Diabetes distress” affects about 1 in 3 people living with type 2 diabetes2. This term specifically refers to the emotional struggles that come with managing the condition. These include the need for constant monitoring and treatment, worry about possible complications, and the strain diabetes can place on personal and work relationships1. Diabetes distress has been linked to higher A1C than someone with less stress, blood pressure, and cholesterol levels1. Stress itself can also trigger the release of certain hormones, which may impact glucose levels3,4. 

“Psychological insulin resistance” is a common reaction to the need to start insulin, often stemming from the belief that needing insulin signifies failure and worsening disease. People who experience psychological insulin resistance may be afraid of injections or doubt their ability to manage their blood glucose with insulin1.  

People who have recently been diagnosed with diabetes may be in denial and therefore avoid treatment, increasing their risk of complications and ultimately contributing to emotional distress1,7. But remember that you are not alone: your healthcare provider is here to help you manage living with diabetes, including mental health issues should they arise. 

 

Diabetes and Anxiety

Anxiety can be heightened in individuals with diabetes; 14% of people with diabetes may suffer from generalized anxiety disorder1,7. Symptoms of anxiety include7:  

  • Feeling a lump in your throat  
  • Restlessness 
  • Feeling on edge 
  • Difficulty concentrating 
  • Irritability 

Irritability and hostility have been linked to fluctuations in blood sugar, sometimes even leading to what is referred to as diabetic rage5. Although this is not the case for everyone living with diabetes, low glucose levels may make staying in control difficult and potentially lead to aggressive behavior6.  

 

Diabetes and Depression

Depression is more common among people with diabetes compared with the general population7. Depression has also been associated with worse glycemic control3. Signs of depression include7:  

  • Feeling tired most of the time 
  • Changes in sleep and eating habits 
  • Trouble with decision making 
  • Feelings of hopelessness 
 

Managing Mental Health7

Acknowledging your feelings is the first step toward managing them. Once you have a better understanding of your condition, you may even find that your anxiety improves.

Increasing your activity level and improving your diet can have a positive impact on your mental and physical health. Stop smoking and avoid alcohol, as both can contribute to poor mental health. If you are having trouble managing mental health issues, there are other options such as medication or therapy.  

Resources and Support

Discuss your stress with your healthcare provider, ask for help from family and friends, get involved in your diabetes community. There are resources specifically tailored to help with the challenges you may face living with diabetes. The CONTOUR®NEXT GEN meter can help you better manage your diabetes and in turn help positively impact your mental well-being. 

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References:

  1. Diabetes Canada Clinical Practice Guidelines Expert Committee; Robinson DJ, Coons M, Haensel H, Vallis M, Yale JF. Diabetes and Mental Health. Can J Diabetes. 2018 Apr;42 Suppl 1:S130-S141. doi: 10.1016/j.jcjd.2017.10.031. PMID: 29650085. 
  2. Heilbrun A, Drossos T. Evidence for Mental Health Contributions to Medical Care in Diabetes Management: Economic and Professional Considerations. Curr Diab Rep. 2020 Nov 28;20(12):79. doi: 10.1007/s11892-020-01337-5. PMID: 33247792; PMCID: PMC8647713. 
  3. Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Ann N Y Acad Sci. 2017 Mar;1391(1):20-34. doi: 10.1111/nyas.13217. Epub 2016 Oct 17. PMID: 27750377; PMCID: PMC5334212. 
  4. Sharma K, Akre S, Chakole S, Wanjari MB. Stress-Induced Diabetes: A Review. Cureus. 2022 Sep 13;14(9):e29142. doi: 10.7759/cureus.29142. PMID: 36258973; PMCID: PMC9561544. 
  5. Hackett RA, Lazzarino AI, Carvalho LA, et al. Hostility and physiological responses to acute stress in people with type 2 diabetes. Psychosom Med. 2015;77(4):458-66. doi: 10.1097/PSY.0000000000000172. PMID: 25886832; PMCID: PMC4431675. 
  6. DeWall CN, Deckman T, Gailliot MT, Bushman BJ. Sweetened blood cools hot tempers: physiological self-control and aggression. Aggress Behav. 2011;37(1):73-80. doi: 10.1002/ab.20366. PMID: 21064166; PMCID: PMC4073202. 
  7. Diabetes Canada. How diabetes can affect your mental health. Available from https://www.diabetes.ca/archive/managing-my-diabetes---archive/preventing-complications/mental-health. Accessed December 18, 2024.