Taking control of your diabetes

Diabetes is an increasingly common disease. According to the Centers for Disease Control and Prevention, 20.9 million Americans were living with diagnosed diabetes in 2011, up from just 5.6 million in 1980. And an estimated seven million more people had diabetes but were undiagnosed. Diabetes goes hand in hand with an increase in obesity and inactivity — both major risk factors for developing type 2 diabetes.

Finding out that you have diabetes can be emotionally overwhelming. Not only are you facing a diagnosis of a chronic illness, you are also dealing with adjusting your lifestyle and daily habits to manage a disease.

Type 1 and Type 2 Diabetes

Type 1 diabetes or insulin-dependent diabetes, is usually diagnosed in children and young adults. There are few known risk factors, though family history may play a role. Type 2, or insulin-resistant diabetes, is most often diagnosed in adults, though the rate of Type 2 in youth is on the rise. In contrast to type 1 diabetes, type 2 may not require insulin injections and can often be controlled with lifestyle changes, oral medications or both.

Obesity, inactivity, family history and poor diet are risk factors for type 2 diabetes.

Diabetes and Stress

Stress has been associated with an increased risk of type 2 diabetes.

When you're under stress, your body signals its nervous system and pituitary gland to produce epinephrine and cortisol, known as "stress hormones." When cortisol and epinephrine are released, the liver produces more glucose, a blood sugar. For people who are already diabetic or at risk for diabetes that extra blood sugar can be dangerous to your health.

Studies show that if you learn how to manage stress, you can better control your blood sugar levels. So regulating stress levels is an important component of treating diabetes.

Seeing a Psychologist about Diabetes

Many diabetes patients find it challenging to make the lifestyle changes necessary to stay healthy, including changing their diet. Making healthy lifestyle choices is important for people with type 2 diabetes. Psychologists can help patients change their behaviors to gradually improve eating habits, activity levels and their overall outlook. They can also help patients learn effective strategies to ensure they regularly test blood glucose, take their medications and complete other diabetes self-management activities.

Often, people newly diagnosed with diabetes have trouble accepting the diagnosis, especially if they feel physically healthy and are not experiencing any symptoms of the disease. Psychologists can help people address emotional reactions such as disbelief, guilt and anxiety and learn how to accept their condition.

Additionally, people with diabetes are twice as likely to have depression as people without diabetes. Symptoms of depression like fatigue and feelings of worthlessness can cause people to ignore their treatment and engage in unhealthy behaviors such as overeating or refusing to take medications. Studies on depression and diabetes show when depression is treated, both mood levels and blood glucose levels improve. Licensed psychologists have the professional training and skills to treat individuals suffering from depression.

Developing a Treatment Plan

Psychologists may work with diabetes patients and their families, either through an independent private practice or as part of a healthcare team in a clinical setting. Sometimes a psychologist will work with diabetes patients who have been referred by a physician, dietician or other health care professional.

In working with a psychologist, you can expect to discuss your overall physical and emotional health, your health beliefs and behaviors. You will also discuss how much you understand about diabetes and your specific diagnosis. 

You’ll talk about all aspects of your life like work, home, family and social situations to help you identify specific challenges you might face. For example, do members of your family prefer to keep unhealthy food in the house or is there a tempting candy jar at work? The psychologist will also discuss what you are already doing well and which behaviors related to diabetes management you can improve. He or she may ask you to keep a diary of different things, such as your eating behaviors, activities, emotional reactions or thoughts. After the initial visit, you and the psychologist will schedule follow-up visits and begin to create a treatment plan.  

Six Steps to Living Well with Diabetes

Consider the following steps that can be helpful in changing unhealthy habits and managing thoughts and behaviors.

1. Get the facts. Learning about diabetes and understanding your specific diagnosis will help you make informed decisions to manage your condition. Prior to a visit to your physician or other health care provider, consider making a list of questions or concerns to address.
2. Accept your feelings. Studies show that people who acknowledge negative feelings about their diabetes are better at caring for themselves and keeping glucose levels stable. For example, if you get anxious by the sight of a sugary snack and how it can affect you physically, pay attention to the feeling instead of ignoring it. Avoiding negative thoughts and feelings about diabetes, like worrying about what to eat, can bring on stress.
3. Maintain a balanced perspective. Don't allow diabetes to become your main focus; the disease doesn't have to define you. You're the same person you were before your diagnosis, so continue to do things you enjoy as you learn to live well with your disease.
4. Be realistic. Rules that are too rigid are more likely to be broken. Set small goals that are easily attainable like walking for 10 minutes a day and slowly building up to 30 minutes or more over several weeks to increase your exercise.
5. Try new things. While diabetes may require significant changes to your lifestyle, it also provides an opportunity to try new recipes, foods or activities.
6. Develop a strong support network. Studies show that people are more likely to follow health regimens when they have a support network. And research specific to diabetes patients found those who have support from family and friends have healthier blood sugar levels during times of high stress. So, communicate with family and friends about how they can help you.

 

The American Psychological Association gratefully acknowledges Teri L. Bourdeau, PhD, ABPP, clinical assistant professor of behavioral sciences and director, behavioral health services, Oklahoma State University, Gareth R. Dutton, PhD, associate professor, division of preventive medicine, University of Alabama at Birmingham, Nutrition Obesity Research Center and Amy Walters, PhD, director of behavioral health services at St. Luke's Humphreys Diabetes Center in Boise, Idaho for contributing to this fact sheet.

Updated September 2013