Prioritising well-being in diabetes management

Published on 14 November 2024

The physical toll of the disease is well-known, but its emotional impact can be just as debilitating. Find out how you can help yourself – and your loved ones – beat diabetes distress.

“I just feel so overwhelmed sometimes,” admitted Sarah (not her real name). “Checking my blood sugar, planning my meals, taking my medications – it’s all just too much.”

Sarah is one of millions worldwide living with diabetes, a chronic condition that requires constant vigilance and self-care. For Sarah, and many others, the physical demands of managing diabetes are only half the battle.

The emotional toll can be just as taxing, leading to feelings of burnout, anxiety and depression – a state known as “diabetes distress”. This often-overlooked psychological aspect of the disease affects more than a third of those diagnosed with diabetes, said Ms Ishwarya Silvaraj, a Clinical Psychologist from the Department of Psychological Medicine at the National University Hospital (NUH).

“Diabetes is not just about managing blood sugar levels,” Ms Ishwarya explained. “It’s also about addressing the emotional challenges, fears and the impact on a person’s overall wellbeing. This is a crucial, yet sometimes neglected, part of effective diabetes management.”

According to statistics from the International Diabetes Federation (IDF), 36 per cent of people with diabetes experience diabetes distress, 63 per cent say that the fear of developing diabetes-related complications affects their well-being, and 28 per cent find it hard to remain positive in relation to their condition.

An emotional toll

There are several negative emotions that can accompany a diabetes diagnosis. This can include the following:

1. Guilt and low self-esteem Patients diagnosed with diabetes may initially blame themselves, thinking they are somehow at fault. “They often feel like they’ve done something wrong, that they’re responsible for their condition,” Ms Ishwarya explained.  This can lead to a lot of negative emotions that make it even harder to manage the physical aspects of the disease.”
2. Burnout Managing diabetes requires constant vigilance and self-discipline, which can become overwhelming over time. Patients may start to feel defeated, as though they cannot keep up, which can lead to burnout – a state of physical and emotional exhaustion. According to Ms Ishwarya, signs of burnout include persistent fatigue, increased irritability, and neglect of essential self-care.
3. Anxiety The prospect of long-term complications – such as nerve damage, kidney disease or vision loss – can be a significant source of fear and distress. Patients often worry about what the future holds, and this fear can lead to anxiety.

Addressing these issues head-on is crucial, as unresolved diabetes distress can hinder one’s ability to effectively manage their physical health. “It can cause people to neglect important tasks like monitoring blood sugar levels, taking medications and maintaining a healthy lifestyle,” Ms Ishwarya added.

Living well with diabetes

Professional psychological support is recommended to address negative emotions, especially when these begin to interfere with daily activities, work or relationships.

To help her patients navigate these challenges, Ms Ishwarya employs a range of strategies, including motivational interviewing and solution-focused therapy. The aim, she explains, is to encourage patients to take things one step at a time, rather than feeling overwhelmed by a seemingly endless list of self-care tasks.

“We start by acknowledging their emotions and normalising what they’re feeling,” she elaborated. “Many patients feel like they’re the only ones struggling with these issues, so it’s important to let them know that their feelings are valid and that they’re not alone.”

From there, Ms Ishwarya works with her patients to set realistic, achievable goals, whether it is something as simple as remembering to check their blood sugar once a day, or finding time for a daily walk. “The key is to break things down into small, manageable steps,” she said. “This way, patients don’t feel like they’re constantly falling short or failing.”

Those living with diabetes should also build a strong support network, both within the healthcare system and at home. Ms Iswarya encourages her patients to bring family members or trusted friends to appointments so they can better understand the challenges of living with diabetes.

“Family and caregivers play a crucial role in supporting patients with diabetes,” she added. “By learning more about the condition and how they can help, they can provide the emotional and practical support that’s vital to managing the disease effectively.”

Ms Ishwarya believes that this holistic approach to diabetes management – one that prioritises both physical and mental wellbeing – helps patients like Sarah thrive. “Diabetes is a lifelong condition, and it’s important to recognise that it’s not just about the numbers on a glucose meter,” she said. “It’s about supporting the whole person, and addressing their emotional needs.”

In consultation with Ms Ishwarya Silvaraj, Clinical Psychologist, Department of Psychological Medicine, National University Hospital (NUH).