Depression diabetes stress

The heaviness and stress of living with diabetes is understood in full measure only by the person experiencing it. Family members who see the burden of daily decision-making required by their loved one with diabetes may also have a pretty good idea of what’s involved, but they are not affected in the same way.

How does a person with diabetes (PWD) manage day after day to cope with the stress that the illness brings? What are some secrets of not only getting to your A1C goal but not letting the strain of diabetes bring you down?

Knowing how to deal with the mental strain is a key component in setting yourself up for success and managing the disease for the long-term.  From interacting with hundreds of patients with diabetes, some conclusions can be made on what actions lead to healthy coping and better disease management.  There are a few things that set apart those who navigate the challenging road well. They have strategies in place which allow them to keep moving forward despite the ongoing responsibility of dealing with diabetes.

People living an empowered life with diabetes incorporate these stress management techniques into their daily routines:

1. Start the day with a plan 

Living with diabetes can feel like a never-ending to-do list.  Plan meals, shop for and prepare food, check blood sugar, record numbers in a log, take medications, do some kind of exercise, make and keep medical appointments, carefully inspect the feet, shop for supplies, and more.  All of this is just for managing one chronic disease, without even considering all of the other things that are involved in life!

Going into a day without a plan or general idea of how you’re going to take care of diabetes throughout the day is a disaster waiting to happen.  A little bit of organization will go a long way toward creating a successful day.  Spend some time each night planning for the next day, or do it early in the morning if you prefer.

Do you have enough carb-appropriate food on hand?  Will you be away from home all day and need to prepare meals and snacks for the road?  How will you incorporate healthy moving into the schedule?  Is your glucometer handy and well-stocked?  Do you have a routine for taking medications each day? Make checklists and set calendar reminders. Thinking through the details of a day before the time comes will allow you to troubleshoot the potential pitfalls and be prepared to handle unexpected schedule changes.

2. Develop healthy sleep habits

The value of good sleep is well-known.  It benefits physical and mental health and improves the quality of life.  Healthy sleep lowers stress hormones and gives the body space to recover from the wear and tear of a day.  The misery of poor sleep is well known. It can worsen depression, anxiety, and stress, and lead to insulin resistance and a weakened immune system.  Diabetes itself leads to a higher risk of sleep-disorders like sleep apnea and restless legs.  At the same time, sleep-disorders lead to poorly controlled diabetes. It’s a vicious cycle.

There are a number of potential causes for poor sleep.  If you are plagued with insomnia or poor sleep quality, don’t ignore it. Seek answers. A sleep study may be needed. Addressing symptoms of neuropathy could potentially help. Reviewing the key points of sleep hygiene can make a difference. Don’t settle for “just being bad at sleeping.”  Talk to your healthcare provider if you suffer from poor quality sleep.

3. Deal with depression and discouragement 

Much of what a person living with diabetes is required to do day after day can lead to discouragement and diabetes-related distress.  If left unchecked, this can lead to worse blood sugar control, less medication compliance and a lack of self-care.  Many people have moments of anger, denial, and discouragement over the fact that they have diabetes. This is normal.

Beyond discouragement, diabetes is known to increase the risk of depression.  True depression can often be found in almost 9% of all PWD.  Those who are willing to seek help when the discouragement or depression come will experience better overall health and quality of life.  If you have been experiencing feelings related to being down, depressed or hopeless, don’t stay in the rut! Reach out to someone! Your family doctor or a trusted counselor is a great place to start.  These symptoms cannot be ignored if you hope to live empowered to make decisions that benefit your life and well-being.

4. Gather a support system 

People living successfully with diabetes have a strong support system of family and friends who offer encouragement to make healthy choices without making anyone feel guilty when they get off track.  These people have your best interest in mind and know when to speak up and when to be silent.  The support system can be helpful at offering solutions or giving another perspective.  The burden of living with diabetes feels lighter when you aren’t experiencing it alone. Allow the people who love you to walk with you on the journey.  Train them in how they can best assist you in reaching your healthy living goals.

5. Incorporate physical activity into the weekly routine 

Oh, the dreaded exercise.  Are you picturing Olympic training while wearing Spandex? An hour or more sweating it out at the gym?  Well, get those ideas out of your head!

People with well-controlled diabetes know that by incorporating moderate physical activity (think: brisk walk) for 30 minutes on most days of the week just makes you feel better.  The psychological, social and health benefits are real.  You truly will reduce your risk of future diabetes-related complications and see lower blood sugar numbers if you get moving.

Do you need help figuring out a way to make it happen?  Find a walking partner.  Schedule time on your calendar. Choose a form of healthy moving that is enjoyable to you.  Have a back-up plan if your routine is dependent on weather or seasons. Don’t start off overly ambitious.  Getting injured is a sure way to see any attempts at exercise go down the drain. Mix up your routine to keep things interesting.  Incorporate weight resistance when you can.

6. Cultivate a resilient mindset

Because diabetes is a life-long illness, you aren’t going to get everything right every single day.  There will be times when you skip medications.  There will be times when you binge eat carbohydrates.  There will be times when you are in denial and want to pretend that this disease doesn’t exist in your life.

Thriving with diabetes requires that you find a way to get past the road-blocks and not let the obstacles send you spiraling out of control.  In other areas of life, when we feel like a failure, it’s easy to just stay on that negative, destructive path and get stuck in the low expectations.  The shame feels heavy. We start believing that things can’t be different for us. We’re not good at anything and never will be.

That simply isn’t true.  Forgive yourself.  Go back to what you know.  One not-so-great decision doesn’t have to lead to a week of neglecting all things diabetes.  Finding a way out of the pit of negative thinking is absolutely necessary.  Those who can bounce back from rough days and get past the feeling of failure see remarkably better results than those who stay trapped by their own destructive thoughts.

What works well for you?

There are likely numerous other strategies for managing the stress of living with diabetes.  The most important element of healthy coping is acknowledging that a chronic disease presents unique life challenges, and accepting that you’re in it for the long haul. 

What have you found to be most effective in this realm?  What advice or tips can you offer other PWD?  Share your struggles and success stories with us.


Li C, Ford ES, Strine TW and Mokdad AH. Prevalence of depression among US adults with diabetes. Diabetes Care 2008 Jan; 31(1): 105-107.
Sleep longer to lower blood glucose levels.  National Sleep Foundation 2016.
Trento, M., Broglio, F., Riganti, F. et al. Sleep abnormalities in type 2 diabetes may be associated with glycemic control. Acta Diabetol 2008; 45: 225.


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