Psychological Effects of Diabetes on Patients

Medically reviewed by Dr. Shunmukha Priya, Ph.D. in Food Science and Nutrition

Diabetes is a disease caused when your blood sugar level is too high. But is it the only problem that comes with diabetes? If you are saying yes, then you should definitely read further into this; because diabetes has much more effects on the human body and also the mind. 

It is imperative to the individuals who are suffering from diabetes, to also understand the depth of this disease on a psychological level too.

Introduction

Diabetes mellitus (DM) is a chronic metabolic disease. According to the International Diabetes Federation (2013), India has around 65.1 million people with diabetes in the age group of 20–79 years.

Most of the diabetic people lead a healthy life with medications and lifestyle modifications. But it is also true that the importance of psychological support that these patients require is unaware or completely ignored.

Several studies including ‘The Diabetes Attitudes, Wishes, and Needs’ study, emphasized that the diabetes patients are given least psychological importance that has resulted in poor quality of life (QoL) and reduced the general well-being [1].

Some of the evidence based studies reported that diabetes and its complications are strongly associated with psychological and psychiatric problems including depression, poor-eating habits, and fear of hypoglycemia [2] [3].

The psychological effects of diabetes also include frequent anger, frustration, hopelessness, fear, guilt and shame and these are said to be most common of all.

Psychological Effects of Diabetes

While most diabetics would have already understood how to deal with their emotional needs and psychological effects of diabetes, there are people who are unaware of this information and are simply assuming these differences in emotions as mental inability.

There is multiple emotional distress in diabetes formulating the psychological reactions in patients. Here is a list that can help you understand furthermore regarding the psychological effects of diabetes:

Emotional/ Crisis Reactions of Having Diabetes:

• Shock
• Denial
• Anger
• Guilt
• Anxiety

Diabetes Distress that Affects the Psychological State of the Patient:

• Overwhelmed for self-management
• Frustrated
• Difficulty in communication
• Distress on differential food in the family

Phobia Reactions that Develops with Time:

• Fear of starting on insulin
• Fear of Needles/Injections
• Hypoglycemia
• Late Complications
• Obsessive Behaviour

Psychiatric Disorders:

• Depression
• Anxiety
• Delirium
• Eating Disorder
• Schizophrenia

Influence Of Diabetes In The Quality Of Life

According to the United States Centers for Disease Control and Prevention (CDC) Quality of Life (QoL) is a multidimensional concept that includes evaluations of both positive and negative aspects of a person’s life [4].

According to the National Institute for Health and Clinical Excellence (NICE) in the United Kingdom [5] report, when a person is first diagnosed with diabetes, they will often go through certain psychological effects of diabetes

• Disbelief
• Denial
• Anger
• Depression
• Acceptance
• Bargaining

When a diabetic patient fails to meet the targets or if they are having hyperglycemia, it will lead them to be more frustrated, angry, denial which in turn can prolong to negative feelings and mental state such as depression, anxiety and stress. 

Also Read: Foods To Eat During Stress And Anxiety

In the long run, this will affect their vascular developing cells, and which can only add to the level of stress and might feel more depressed. 

There is a stage where the clients may self-medicate and give up on medications. Complex environmental, social, behavioural, and emotional factors involve psychosocial behaviour of an individual living with diabetes, both type 1 and type 2.

Diabetes is a self-managed condition. This means that the person with diabetes is responsible for taking care of him or herself on a daily basis. At times neuroleptics medications also lead to weight gain, that is, when an individual is in Depression and Anxiety which can be difficult for the person to exercise regularly and eat healthily because of the least motivation in self.

How To Resolve These Negative Emotions:

1. Enrolling and following a diabetes management program:

Through proper guidance on medication, diet, water intake and physical activity; Eating healthy and lifestyle modifications, one can maintain a healthy weight and meet blood sugar targets. Having enrolled in a diabetes management program can bring in the discipline and motivation to fight this disease off.

Also Read: A Guide To Manage Diabetes With Healthy Food

2. Monitoring of regular Blood glucose levels pre and post meals as well as pre and post workouts:

Checking sugar levels pre and post meals will give a better understanding of the blood sugar pattern and customize the meal plan accordingly.

Checking the sugar before exercise will help understand the parameters more precisely and thus making them updated and unworried during exercise.

3. Taking proper dosage of medications and proper insulin units on time:

Taking medications at the proper time every day and regularly checking blood sugar to ensure the levels are within their ideal range, can help people regulate their glucose levels and their moods.

Having a disciplined routine not only helps you deal with diabetes but also keeps you mentally stable and confident about recovering.

4. Healthy Diet at regular intervals: 

Keeping a routine and having a regular meal at a fixed time can improve blood sugar levels. Include functional ingredients suitable for diabetes as per the nutritionist suggestions.

Eating as many nutritious foods as possible is highly advantageous. Enquire multiple health recipes that are tasty and also fulfills your cravings. Avoid or stop consuming junk foods.

5. Regular physical activity :

Daily engage in 30 to 45 mins of physical activity. That can be a favourite outdoor game that you enjoy or brisk walking, yoga; This will not only help in controlling the sugar levels but also keeps you relaxed.

If you have not been exercising for a long time, then make sure to consult your doctor before starting. They might as well suggest you certain exercises that can be best for you.

6. Family and Friends:

To fight diabetes, one will need emotional support. This is why, having your family and friends beside you is particularly important.

You will need someone whenever any issues arise, to support you and help you deal with fear to face the challenges of life as well as diabetes.

Conclusion

The association between diabetes and psychosocial disorders is multifactorial. Addressing the psychosocial needs of the diabetic patient would overcome the psychological barriers and will result in achieving long-term benefits in terms of better health outcomes and glycemic control.

If ignored, a diabetic patient may suffer from serious psychological and emotional impact as well. This could easily affect their self-management ruining their quality of life. 

While depression and anxiety has been gaining its importance to be treated on, the relation of these with diabetes is yet to catch up on its significance.

Case Study:

Background:

A 42 years old, unmarried client was pursuing his Ph.D. when he joined Possible and was in the last phase of submitting his thesis. He has been diagnosed with Diabetes Mellitus since the age of 33 years.

Case Presented by: 

Mrs. Rhucha Mahulkar, Deputy Nutrition Manager, Possible Wellness Pvt., Ltd., Pune.

Reasons:

• Genetics: The client was hailing from a strong family history of diabetes and heart disease.
• Diet: The client was busy with research work and also being unmarried resulted in an unattended diet. He generally consumed foods that are easily available in and around his institution.
• Activity: Being a research scholar, he was spending most of his time in the library and hardly got involved in any physical activity. In fact he had zero investment in exercise or a simple walk due to his knee pain. This resulted in obesity.
• Stress: Being in the final phase of thesis submission, he was experiencing severe stress. Also, adding up to this was the fact that failing to submit the thesis could have led him to serious complications, financially.

Although his work did involve moving around the classroom, he could not do so due to his knee pain. This again caused more stress of disadvantage on the thesis.

• Others: Due to obesity, he hardly had energy for the whole day. This led to tiredness and fatigue. He had a low self-esteem and was at loss of confidence due to the social comments made on his appearance.

Management & Outcome:

• To start with, he was asked to walk for 10 minutes per day and was increased gradually. Now he can walk upto 30-45 mins and also climbs up and down 3 floors in the University.
• He was given with small and frequent meals and healthier options to eat.
• Performed several motivational activities involving him, which brought a lifestyle change inside him, reviving his well-being.
• He was asked to include fruits and salads in his daily diet. Fruits were included once a day and salads in all the meals. Serving size of fruits was kept to 75-100 gm a day and salads was around 50-75 gm with every meal.
• Being a diabetic, regular sugar tests were done. He goes for regular follow ups to his physician. His sugar levels are updated in the profile. There was a time when the doctor had completely stopped his post lunch dosage, and the sugars were monitored.
• Every call made to him was about imparting nutritional knowledge and motivational talks.

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