May 27 2022

The mental health challenges of living with diabetes.

Any physical illness can have an impact on your mental health too. Diabetes is no different.

According to the U.S. Centers for Disease Control and Prevention, people with diabetes are between two and three times more likely to suffer from depression than people without diabetes. But fewer than half get diagnosed and receive the mental-health support they need.

Managing diabetes is tough. It requires lifestyle changes, near-constant monitoring, and the administration of insulin whenever needed. For many, the risk of a hypoglycemic episode is ever present – further adding to the mental burden. Sleep is often disrupted too, as night-time checks may be needed to ensure blood glucose is within a safe range.

The mental-health challenges associated with diabetes can also affect family members. The parents of a newly diagnosed child may experience feelings of sadness and guilt, while siblings may resent the impact diabetes has on the whole family. Eating habits may need to change, for example, and there is likely to be a lot more focus on the child with diabetes – at least in the short term. All these factors can cause mental strain.

“Research suggests that people with pre-existing mental illnesses may be more prone to developing type 2 diabetes.”

The two-way challenge.

There is also a bi-directional aspect to diabetes and mental health that is only now starting to get more attention: research suggests that people with pre-existing mental illnesses may be more prone to developing type 2 diabetes.

Nanna Lindekilde, a researcher from the psychology department of the University of Southern Denmark, published a paper on the subject in late 2021. Linekilde and her team screened four electronic databases and found 32 reviews based on 245 primary studies linking mental disorders with diabetes.

Using 6-9% as the baseline level for prevalence of type 2 diabetes in the general global population, Lindekilde’s research revealed higher diabetes prevalence among people with sleep disorders (40%), binge-eating disorders (21%), substance-abuse disorders (14%), anxiety disorders (14%) and bipolar disorders (11%).

It’s easy to see how there can be a cause-and-effect mechanism at work here when it comes to type 2 diabetes. People who suffer from mental health issues may smoke and drink more, neglect exercise and eat badly. These are all factors that can lead to poor glycemic control.

A holistic approach.

What then is being done to address these challenges? As always with healthcare, initiatives vary from country to country.

Last year’s European Mental Health Week was supported by the International Diabetes Federation, raising awareness around diabetes burnout, fear of hypoglycemia, body image, stress, anxiety and depression.

One of the most interesting initiatives is the award-winning 3 Dimensions of Care for Diabetes (3DFD) project in the UK. Driven by the famed King’s College Hospital in London – working in partnership with local communities – 3DFD is a multidisciplinary service that integrates social, psychological and diabetes care.

Some 300 patients with diabetes and mental-health related issues pass through the service each year, with results that other countries should be looking to emulate. Since its launch just over a decade ago, 3DFD has recorded metrics such as a 45% reduction in emergency visits among people with diabetes, 22% fewer hospital bed days, and cost savings of GBP 850 per patient over a 12-month period.

If you struggle with mental-health issues of any kind, do not hesitate to contact a doctor or helpline in your local area.

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