Conquering Diabetes Distress To Maintain Quality of Life

Rather than a medical outcome, quality of life is a steady pursuit. Here’s how you can cultivate it.



Third and concluding article in our Quality of Life series

In the first part of our series, we wrote about a 2016 survey of people who have diabetes and feel that their care routines have been thrust upon them. We cited diaTribe’s Adam Brown who, in a 2017 speech, noted that fewer than a third of people with diabetes feel they’re successfully meeting their health goals. Undermining their efforts are the fatigue and stress that come from the relentlessness of the task, along with the other stressors in life that meddle with metabolic functions and their efforts at self-care.

Stress triggers the body’s natural defenses. One is the release of glucagon, the very thing that pushes glucose levels higher, to nourish bodies and keep brains awake. Dr. Lawrence Fisher, also referenced in the first part of the series, describes a the “fight or flight” defense mechanism humans have inherited. Cortisol, a natural steroid hormone, also prepares the body to handle a stressful situation by flooding it with stored glucose and fats to fuel muscles. At the same time, cortisol gets the blood pumping faster, elevating blood pressure, and making the large fight or flight muscles less sensitive to insulin. This cascade of hormones and nutrients is something that the body of a person who has diabetes already has trouble handling. So, diabetes-related stress, or diabetes distress as Dr. Lawrence terms it, has behavioral as well as biological consequences. “In fact,” he wrote, “many clinicians consider a person’s levels of distress and depression to be as important to health as measures of blood glucose, cholesterol, blood pressure, and weight.”

Healthy diets don’t tax the body with sugar and salt and fats. Regular exercise maintains quality in the muscular-skeletal and respiratory systems. Anti-diabetic medications compensate for metabolic weakness — the limited or lost capacity to control blood sugar — but quality of life requires maintaining more than just metabolic control.

Here are some proven methods to improve the quality of your living experience:

Connect With Others

There are 28 to 29 million American adults who have been diagnosed with Type 2. People trying to solve a problem they have in common naturally gravitate to lift each other up, and to do that pass around a kind of human currency. Beginning in the 1980’s web chat rooms and blog sites caught on as forums for people with diabetes to exchange their personal stories and share leads to self-help resources, before long growing into the Diabetes On Line Community of patients, care providers, and advocates of innovative care. It’s only recently that people with Type 2 have been adding their voices to the online forum, and so Type 1 sites and discussion groups still have the bulk of the web presence. But stress is an equal opportunity troublemaker, no matter how and when one’s diabetes originated. With a little clicking around, you can connect with a coach or a blogger, or a webcast service, and search out what others do to minimize the stress of living with diabetes. Facebook has a diverse and lively following among people in the online diabetes news community. Be sure to combine what you learn with guidance from your professional care provider.

Be Good to Yourself

Shouldering the personal responsibilities of diabetes care takes energy and persistence, and a willingness to be realistic about expectations. Striving for perfection, whether in an A1c level or a number on a bathroom scale, can lead to anger and resentment when the target is missed.

We’re humans, and although we share an illness, we are each as different in our genetic makeups and metabolisms as we are in the things that happened in the past and opened the doors to developing Type 2. The clinical literature points to fallacies that many people sadly dwell upon when first diagnosed: that a lack of will power to cease immoderate behaviors, and a stubborn disregard of physician advice and concern expressed by loved ones, are the things that caused the diagnosis. Allowing that thinking to persist becomes a burden very hard to put down, especially for those who believe in another fallacy — that it’s selfish to let go of it.

Nor is it selfish to round out good health efforts by setting aside time every day, away from the business of life’s routines, for reading, writing in a journal, listening to music, or working at a creative hobby.

The National Center for Complementary and Alternative Health, established at the National Institutes of Health in 1998, publishes a newsletter featuring not only professional practice materials but resources for patients. Integrative medicine draws together practitioners in the disciplines of yoga, massage therapy, relaxation and meditative therapies, and traditional mind and body healing arts, all things known to relieve stress and help people battle complications of chronic illness. It’s important to keep your mind open to opportunities to care for your inner being in spirited and intentional ways.

Be sure to discuss your interest in alternative and holistic healing with your doctor before deciding to adopt a complementary therapy regimen.

Staying Engaged In Your Professional Care

The second article in this series, focused more on seniors, encouraged them to be candid with their care professionals about all aspects of their lives; in truth that’s sound advice regardless of age. The anxiety that accompanies diagnosis, or the onset of a complication of diabetes, or a change in treatment, is something to be expected; just remember that it’s the body’s, and the mind’s, natural response to help prepare you for the challenges ahead.

Of course, lingering problems with irritability, restlessness, sleeplessness, and fear, brought on by the uncertainties of success with diabetes self care, are not natural, nor helpful. They are warning flags for serious, debilitating anxiety disorders and depression, problems no one can be expected to battle alone. Experience among physicians who work with chronically ill patients, reported consistently throughout the medical literature, has demonstrated that uninhibited doctor and patient conversation itself brings about a therapeutic benefit the patient can feel almost immediately. It slows down the emotional anticipation machine. And because it enables you to pivot in a better direction, it’s a powerful tool when it comes to quality of life.

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Jim Cahill is a senior writer for Insulin Nation and Type 2 Nation. Before turning to writing, he was a lawyer in government and private practice who focused on consumer protection and regulatory law. He can be contacted at jcahill@epscomm.com.