Diabetes distress: the psychological burden of living with diabetes

Living with type 1 or type 2 diabetes requires patient's sustained engagement with multiple self-care behaviours including medication taking, healthy eating, and glucose monitoring. The ongoing demands of self-care coupled with a fear of complications takes a toll on these individuals. Diabetes distress refers to the emotional effect of living with diabetes and can include feelings of guilt, anxiety, and concerns about self-managing the condition. Six domains have been identified in relation to diabetes distress, namely: treatment regimen, food and eating, future and complications, hypoglycaemia, social and interpersonal relationships, and interactions with health-care professionals. 1 Dennick K Sturt J Speight J What is diabetes distress and how can we measure it? A narrative review and conceptual model. J Diabetes Complications. 2017; 31: 898-911 Crossref PubMed Scopus (92) Google Scholar Although symptoms of diabetes distress can include low mood, these feelings are centred on diabetes-related difficulties. In this way, diabetes distress is distinct from other forms of distress, such as depression, which is also prevalent in individuals with diabetes. Despite the conceptual overlap with depression, diabetes distress is not considered a psychiatric disorder. Diabetes distress is common and enduring, with prevalence estimates of more than 20% for both type 1 and type 2 diabetes. 2 Skinner TC Joensen L Parkin T Twenty-five years of diabetes distress research. Diabet Med. 2020; 37: 393-400 Crossref PubMed Scopus (0) Google Scholar Given the stigma of poor mental health in some communities, the higher burden of diabetes among Black people and South Asians, and the higher reporting of diabetes distress symptoms among ethnic minorities, distress in diabetes might contribute to inequalities in diabetes.