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Living with Diabetes: What to Do When Your Mental Health Feels “Off”

 |  For Patients

From tracking blood glucose levels to planning meals and taking care of your physical needs, managing diabetes can be physically, mentally and emotionally draining. It’s completely normal to feel sad, stressed, or emotional about it.

People living with diabetes are 2-3 times more likely to experience depression and 20 percent more likely to have anxiety than people without diabetes.
Centers for Disease Control, 2022

Mental health plays a large role in diabetes management. According to the American Diabetes Association, there are several mental and emotional health complications that may arise when living with diabetes. It’s important to know the signs of each and what to do if they arise in you or someone you care about.


Anger can be a challenge from the beginning as you wonder why this has to be your new way of life. You may feel you’ve lost control, and this causes you to feel weak or more vulnerable to your health than ever before.

Know the Signs:

  • Refusing to care for your diabetes
  • Unusual anger towards friends or family members

Managing Anger:

It’s okay to be angry, but finding ways to manage your anger is key to managing your diabetes and maintaining your overall health.

  • Identify what is causing you to get angry
  • Practice healthy responses to your anger (taking a breather or taking a walk)
  • Journal to get your feelings out on paper, which can help you gain perspective or note cyclical mood swings
  • Join a support group of people living with diabetes
  • Don’t be afraid to ask for help – counseling may be beneficial


Short-term denial is extremely common and eases many people into their new routine, but long-term denial of diabetes can prevent you from managing your health effectively.

Know the Signs:

  • Not testing your blood glucose
  • Ignoring a meal plan
  • Not checking your feet for signs of trouble each day
  • Smoking

Managing Denial:

  • Create a plan with realistic personal healthcare goals
  • Ask your friends and family to encourage you stay on the right track to attain your goals
  • Reach out to healthcare professionals who can help you with specific issues you are dealing with such as diet and basic diabetes management
    • Ex: Reaching out to a nutritionist could alleviate stress about your diet.

Tip: ACN’s Care Coordination team is available to all patients whose Primary Care Provider is part of Arizona Care Network. Our team can help you find a nutritionist, or any other needed specialist, in your network who can help. Contact the ACN concierge line at 602.406.7226 to get the care you need.

Diabetes Distress

Diabetes distress happens when a person living with diabetes experiences high levels of stress and depressive symptoms without reaching major depressive disorder.

1 in 3 adults with type 2 diabetes experiences diabetes distress.
Centers for Disease Control, 2022

Know the Signs:

  • Regimen distress: Stress from managing testing, medications, diet, exercise routine, etc.
  • Concern with the future: Constant worry about a future with diabetes and the possibility of developing complications
  • Worry about the quality of care you are receiving from doctors and the cost of that care
  • Social burden: The stigmas behind diabetes begin to take a toll on the patient
    • Example: People mistakenly believe someone developed diabetes because they ate too much sugar growing up

Managing Diabetes Distress:  Occasional distress is normal for people living with diabetes and does not always require a doctor’s care.

  • Try taking things one day/one step at a time
    • Ex: Don’t try to change your diet and exercise routine all in one day
  • Set realistic goals and strive for small progress
  • Keep striving for good results, but try not to get frustrated when they don’t happen as quickly as you’d like
  • Talk about your diabetes with a healthcare provider, family and friends, and other people with diabetes


An extreme sense of sadness that will not go away can cause major roadblocks in effectively managing your diabetes.

Know the Signs:

  • A loss of interest/happiness in doing things you once enjoyed
  • Change in sleep patterns
  • Waking up earlier than normal because of your inability to sleep
  • Eating more or less than you used to
  • Difficulty concentrating
  • Constant tiredness
  • Anxiety
  • Guilt
  • Morning sadness is worse than any other time of the day
  • Suicidal thoughts

Managing Depression

  • Consult with your doctor to rule out physical causes such as low or high blood sugar
  • Attend counseling with a mental health professional
  • A psychiatrist may prescribe medication to treat depression
  • If you are considering hurting yourself or others, please call the National Suicide Prevention Lifeline immediately: 1-800-273-8255 (TALK)

Eating Disorders

Already common among the general female population, research suggests eating disorders are even more prevalent among females living with diabetes. However, eating disorders also occur among men, so it’s important to know the signs. Eating disorders combined with diabetes can become extremely serious.

Know the Signs:

  • Unexplained increase in A1C levels
  • Repeated episodes of diabetic ketoacidosis (high levels of blood acid that causes vomiting, excessive thirst, shortness of breath, etc.)
  • Obsessive concerns over body size/shape
  • Excessive exercise resulting in hypoglycemia (lower blood glucose than normal)
  • High interest in low-calorie meals
  • Absence of menstruation

Managing Eating Disorders:

  • Seek help from a team of medical professionals including a mental health professional, endocrinologist, nurse educator, nutritionist and other professionals as needed
  • Ongoing therapy may be necessary

If you experience any signs of common mental health complications listed above, always consult with your doctor. They will be able to establish the best care plan for you. If your Primary Care Provider is part of ACN, our care coordination team can also help you find the specialists you need to improve your overall health. Contact the concierge line at 602.406.7226.

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