Diabetes-Related Distress

Diabetes-related distress (DRD) is the worry and concern that many of you with diabetes experience related to management of the disease, fear of complications, and perceived lack of support from healthcare providers and your social network. It's been associated with poor self-care, high blood sugars, increased risk of diabetes related complications and lower survival rates.

The Mayo Clinic recently posed four questions to some of the patients in their diabetes clinic. Here are the questions and some of the responses.

#1. Have you experienced diabetes-related distress and, if so, how does it affect your health and management of your diabetes? How does it affect your life in general?

• "Most definitely! I get depressed at times and very frustrated … asking 'why me'? Low self-esteem."
• "Yes. It affects my health in regards to the need to be more vigilant with dietary intake, times to eat and trying to eat 3 meals a day. In general it affects my life in regards to thinking how this chronic disease is affecting my overall life and lifespan."
• "Yes I would say I have experienced DRD. I have found with medications being adjusted I have felt as though I have to learn what the medications do so I can adjust my eating to help my numbers turn out good, (not that I always do).
• "Taking a test 4 times a day has been a little bit of a hassle cause you can't eat for 4 hours before the test, and sometimes it would be very nice to just be able to grab a carrot or something cause you're hungry, but you can't because of the test, which tends to make me overeat when I can eat.
• "Fear of having the blood sugar drop and the feeling I get with it, it seems to take a while afterwards to just feel better, and it feels like it just hits real fast no warning, it has been kind of scary. Dietary restrictions are kind of 'not fun', but that is because I have mastered eating quite well, and should address this whether I am diabetic or not, it does sometimes not make sense to me what makes my sugars go high and other times some things that don’t make it go high.
• "Exercising is a real struggle for me, working full time, being a mother of very active son, being tired; it just makes it very undesirable to add more on.
• "Challenging myself to keep accurate records, record them, see how many days in a row I can keep blood sugar levels below a certain level. Not foolproof, but it is keeping me motivated."

#2. What do you find helpful in reducing your level of diabetes-related distress?

• "Exercising helps me a lot. Especially walking with my friend or also interacting with other friends socially and family. "
• "Regular visits with health care providers. Consistent monitoring of blood sugars and of course having blood sugar reading at or near your goal level."
• "I guess for me reducing the DRD, prayer should be my key, but having accessibility to contact health care providers when I have questions is very helpful. Learning to discipline myself would be a key, not that I have, but I am working on it."

#3. What have your healthcare providers done in the past to help you combat diabetes-related distress? How could healthcare providers or others do a better job of helping you deal with DRD?

• "I think networking with other diabetics would be great! I can honestly say I have not heard of a 'Diabetic Club' or organization."
• "I really believe the consistent contact I had with the diabetes service here was valuable in reducing my stress levels. From offering reassurance, trying different treatment regimens and having the ability to meet the patient at 'their level' of acceptance/denial/fear of the disease was paramount in helping with my DRD."
• "My healthcare providers have encouraged me to exercise more, lose weight, always in a positive way. Also suggested that if I lose some weight, I could possibly reduce the amount of insulin used. They have made themselves available if I have questions, and provided training and information. I really don’t have any suggestions as far as helping deal with DRD."

#4. If you have other chronic health conditions, how does diabetes related distress compare to distress from other conditions? Is it different? If so, how is it different?

• "I think for me it is different than my other medical co-morbidities. The fact you need more close monitoring and the fact of being IDDM (insulin-dependent diabetes mellitus) you are reminded on a daily basis the seriousness of the disease."
• "Diabetes just has to be monitored so much more throughout your entire waking day, it seems to be much more of a constant chore than any other I have experienced."

Please read the full article and the comments following it as some are very interesting and to the point.