Diabetes Distress: Teen Version

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KEY POINTS

• Diabetes distress means that you feel overwhelmed, frustrated, sad, worried, or angry because of the demands of living with diabetes.
• It helps to work with your treatment team. They can help you deal with the physical and emotional effects of diabetes. Take things one step at a time. Don’t try to change everything at once.
• Consider joining a support group in your area. Sometimes it is helpful to talk with others who have similar struggles.

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What is diabetes distress?

Diabetes is a long-term disease that may never go away completely but can be managed successfully. Living with diabetes is not easy. Besides dealing with symptoms, it also involves keeping track of medicines, checking blood glucose (sugar), seeing healthcare providers, and making lifestyle changes. Diabetes distress means that you feel overwhelmed, frustrated, sad, worried, or angry because of the demands of living with diabetes. Signs that you may have diabetes distress include feeling that:

• Your healthcare provider doesn't know enough about diabetes and diabetes care.
• Diabetes takes too much of your mental and physical energy every day.
• You may not be able to manage diabetes day-to-day and keep up with the demands of living with diabetes.
• You get angry, scared, or sad when you think about living with diabetes.
• Your healthcare provider doesn't give you clear enough directions on how to manage your diabetes.
• You are not testing your blood glucose levels often enough and worry that you’ll have dangerously out of control blood glucose levels.
• You will end up with serious long-term complications no matter what you do.
• Your family members or friends plan activities that conflict with your schedule, or they want you to eat foods that are not part of your meal plan.
• Diabetes controls your life.
• Your healthcare provider doesn't take your concerns seriously enough.
• You are not sticking closely enough to a healthy meal plan, and you must think about food choices all the time.
• Friends or family don't appreciate how hard it is to live with diabetes and don’t seem to support you.
• You’re not always motivated to keep up your diabetes self-management.

How can I take care of myself?

• Get support. It is important to work with your treatment team. They can help you deal with the physical and emotional effects of diabetes. Make sure you meet with your treatment team:
  • When you are first diagnosed
  • Once a year for a checkup or more often as advised by your treatment team
  • If you develop new symptoms or a new health condition
  • If you feel stressed, frustrated, sad, worried, or angry
  • If you are pregnant or plan to become pregnant
  • If other things in your life change that might affect the way you manage your diabetes

  Depression is different from diabetes distress. Depression is feeling sad, hopeless, and uninterested in daily life to the point that it keeps you from doing everyday tasks. If you feel this way, talk to your healthcare provider. Your provider may advise different treatments and refer you to a mental health professional who works with people who have diabetes.

• Talk with family and friends. Consider joining a support group in your area. Sometimes it is helpful to talk with others who have similar struggles.
• Learn about your condition. Work with a certified diabetes educator. Knowing how diabetes affects your body helps you better understand how treatments, medicines, and lifestyle changes can help you manage the condition and stay as healthy as possible. Know what symptoms need to be treated right away and when to call your healthcare provider. Ask if a continuous glucose monitor (CGM) is right for you. The device can help you closely monitor your blood glucose levels and decrease fear that your glucose levels will fall too low or rise too high.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the prescription and nonprescription medicines, natural remedies, vitamins, and supplements you take. Take all medicines as directed by your provider. Talk to your provider if you have problems taking your medicine or if the medicines don't seem to be working.
• Set up a routine. A key part of managing diabetes is setting up a good routine. It helps if you plan and follow a schedule for meals, physical activity, sleep, and medicines. A good routine can help keep your blood glucose from getting too high or too low.
• Learn ways to manage stress. Take things one step at a time. Don’t try to change everything at once. Find ways to unwind such as by taking up a hobby, listening to music, watching movies, reading, or walking. Learn ways to relax such as by deep breathing, mental imaging, mindfulness, or relaxing muscle groups one at a time. Yoga and meditation may also be helpful.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Follow a healthy meal plan. Limit caffeine. If you smoke or use e-cigarettes, try to quit. If you are of a legal age, it may be OK for you to drink alcohol sometimes if you don’t have any complications and your blood glucose is in good control. If you choose to drink alcohol, limit it to 1 drink a day for women and 2 drinks a day for men. A drink equals 12 ounces of regular beer, 5 ounces of wine, or 1 and 1/2 ounces of 80-proof distilled spirits. Stay physically active as advised by your provider.
• Take care of your emotional health. You can manage your diabetes successfully. Try not to worry about things you can’t control.
• Contact your healthcare provider if you have any questions or your symptoms seem to be getting worse.

What can I do to help my loved one with diabetes distress?

• Offer support in a way that helps the person feel in control. Don't nag or criticize. Managing diabetes is hard work 24 hours a day, 7 days a week. Knowing that you are willing to support the person helps them more than trying to control their food choices and blood glucose testing.
• As much as possible, join the person in following a healthy meal plan and being physically active. It's helpful if a person with diabetes doesn't feel like they're the only one who is cutting back on foods such as ice cream, chips, sugary drinks, candy, and cake.
• Understand that low blood glucose can cause a person with diabetes to feel shaky, weak, confused, and irritable. Try not to take it personally. If you feel frustrated or afraid that the person is not managing well, talk with a healthcare provider or counselor who works with people who have diabetes.
• Let the person talk about their diabetes, treatment, and feelings. Really listen to what they say. Let the person know that it’s OK to feel sad, confused, angry, or afraid. Having someone listen can be comforting.
• Encourage the person to stay active and enjoy hobbies or special interests. Encourage hope and humor.
• Help the person keep as normal a routine as possible.

Seek help from a healthcare provider or therapist if you or someone you love feels overwhelmed. Get emergency care if you or a loved one has thoughts of suicide or self-harm, violence, or harming others.