Coping diabetes distress: Learning, connecting, and engaging

This article was exclusively written for The European Sting by Ms. Sadia Khalid, an early-stage researcher (ESRs) at Tallinn University of Technology (TalTech), Estonia. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Diabetes is a relentless disease. Managing diabetes can be a tough responsibility. Diabetes comes with more commitments than any other chronic disease where patients must check their blood sugar levels often, make healthy lifestyle choices, eat healthy, be physically active, remember to take their medicine, and make numerous other good decisions in a day for its management.

What worries patients the most is the nagging fear of getting complications in the future or anxiety and fear of going off track with diabetes management. Let’s not forget the patients with no universal health coverage anxiety and distress can also root from healthcare services and medicine costs and the worry of this cost to go up when they will develop diabetes-related complications, such as heart disease or nerve damage.

When all this feels like too much to deal with, what emotion and helplessness patients experience is something we call diabetes distress. This all worry, frustration, anger, and burnout make it hard for a diabetic patient to manage and keep up with demands of their diabetic.

Living with diabetes can be overwhelming at times. Diabetic stress isn’t the same as depression. But diabetes distress can easily turn into depression if the distress persists for a while. One in four people with type 1 diabetes have high levels of diabetes distress, as do one in five people with diabetes. It is important that community health centres provide diabetic patients and their families with awareness/educational material on how to cope with diabetes and manage stress. Here we talk about a few of those tips.

1. Be kind to yourself, take a break, and pay attention to your feelings. Letting go of higher expectation and outcome of management is a first step while tackling any chronic disease. Almost Everyone feels frustrated or stressed from time to time. And living with a chronic disease with high demands can really add to these feelings and make one feel overwhelmed. High blood sugar levels even with good management isn’t a reflection of how bad a patient is managing no one has a perfect relationship with diabetes. Diabetes is hard and you shouldn’t blame yourself for it. As sad as it might sound, you can’t completely take a break from its care, but you can choose to spend a bit less time and energy on it. If these negative feelings persist for more than a week or two may signal that you need help coping with your diabetes to feel better again.
   
2. Make time for your enjoyment. We all need a break! It’s so important not only for diabetic patients but for anyone with chronic illness to Set aside time every day to do something you really love; it could be working on a fun project or meeting an old friend. Find out about activities near you that you can do with a friend. And find Facebook groups and local communities where diabetic patients organize regular meet and greet to connect.
   
3. Pace yourself. As you work on your goals, like increasing physical activity, take it slowly. You don’t have to meet your goals immediately. Your goal may be to walk 10 minutes, three times a day each day of the week, but you can start by walking two times a day or every other day.
   
4. Discuss with your health care providers. Talk to your doctor, nurse, diabetes educator, psychologist, or social worker about your distress and feelings. It’s important to discuss on regular visits how you’ve been feeling. They can help you with your concerns and may provide solutions. They may also suggest other health care providers for further help.
   
5. Talk to your health care providers about stigma or judgements other people may have about your diabetes. It is important that you must not hide your diabetes from other people due to judgement and fear of negative stigma as it can really hinder your diabetic care.
   
6. Ask if financial resources are available for the costs of diabetes medicines and supplies. Talk with your pharmacist and other health care providers about the cost of your medicine and possible funding resources available by government or NGOs or diabetic organisations if you are worried about medical costs and lack universal health care coverage or health insurance. They may know about government or other programs that can assist people with costs. You can also check with community health centres to see if they know about programs that help people get insulin, diabetes medicines, and supplies (test trips, syringes, etc.).
7. Talk with your family and friends. Tell friends and family how you feel. Be honest about the problems you’re having in dealing with diabetes. Sharing how you feel helps to relieve stress. However, sometimes the people around you may add to your stress. So be mindful. Manage in a way where you let them know how and when you need them to help you.
   
8. Allow loved ones to help you take care of your diabetes.  Their help can come in several ways. They can remind you to take your medicines, help monitor your blood sugar levels, join you in being physically active, and prepare healthy meals. They can also learn more about diabetes and go with you when you visit your doctor. Ask your loved ones to help with your diabetes in ways that are useful to you.
   
9. Connect with other people with diabetes. Shared experiences will allow other people with diabetes understand some of the things you are going through. Ask them how they deal with their diabetes and what works for them. They can help you feel less lonely and overwhelmed. Ask your health care providers about diabetes support groups in your community or online.
   
10. Do one thing at a time. One step at a time. When you think about everything you need to do to manage your diabetes, it can be overwhelming. To deal with diabetes distress, make a list of all the tasks you must do to take care of yourself each day. Try to work on each task separately, one at a time.

Remember that it’s important to take care of yourself emotionally while managing diabetes and be honest about your feelings to yourself and then to your healthcare provider. If you notice that the feelings of frustration, tiredness, and indecisiveness about your diabetes care aren’t getting better, act quickly. Be honest with your family, friends, and health care providers without thinking of judgement. Because there is no shame in getting help and these people can help you get the support you need.

About the author

Sadia Khalid, early-stage researcher (ESRs) at Tallinn University of Technology (TalTech), Estonia. She has been working on her PhD research project  “The role of Helicobacter pylori intestinal microbiota in the development of liver diseases. under supervision of Dr. Pirjo Spuul at Faculty of Science, Institute of Chemistry and Biotechnology.,TalTech. Her current research interests include infectious diseases, bacteriology, hepatology, and gastroenterology.