Feeling Overwhelmed by Diabetes? Understanding Diabetes Distress Can Help.

By Ashlyn Smith, MMS, PA-C, DFAAPA, LSC

ELM Endocrinology & Lifestyle Medicine

Diabetes is a complex, daily disease and there is never a day off. Managing such a complicated disease demands constant mental and emotional energy, vigilance, and adjustment as new information and variables arise. If you ever feel overwhelmed, frustrated, or defeated about handling diabetes, know this: YOU ARE NOT ALONE!

You may be experiencing diabetes distress: a common, understandable, and very real emotional response to living with the ongoing demands of living with diabetes. Diabetes distress is normal—in fact, medical professionals do not consider it a disease because it is such a normal response.

Stressed over diabetes? That's normal and you are not alone!

Understanding Diabetes Distress

What is it?

Diabetes distress is the emotional burden of managing diabetes 24 hours a day—balancing glucose levels, complications, treatment, and financial and social impacts. Healthcare professionals ask people living with diabetes to do many things on a daily basis:

·       Monitor glucose

·       Balance nutrition and physical activity

·       Administer medications correctly

·       Time medications appropriately

·       Take these medications with meals and these without

·       Some are oral, some are injectable, some may be inhaled

·       Remember which are weekly, daily, and multiple times a day

·       Preventing and preparing for hypoglycemia

·       Screen for and manage complications (and even more medications!)

·       Miss school or work for appointments and troublesome glucose days

·       Navigate financial and social impacts

This list is not exhaustive and does not account for the interpersonal factors of your relationships with family and friends, social dynamics and pressures of culture, and internal dialogue that may cause shame and blame.

Diabetes distress can progress to diabetes burnout, a state of physical and/or emotional exhaustion, detachment, and hopelessness about diabetes care.

What can it look like?

• Triggered by: 

  • The initial diagnosis of diabetes as well as any diagnosis of complications or comorbidities

  • Treatment changes

  • Social stigma

  • Feeling overwhelmed

  • Financial stressors

  • Good A1C doesn’t mean low distress—you can look "fine" clinically while struggling emotionally

• Common concerns: 

  • Fear of complications

  • Guilt over not doing enough or self-blame

  • Feeling as if you are not on the same page as your diabetes provider

  • Concerned that you are failing at your diabetes routine

  • Lacking support from friends and family

  • Pressure from loved ones that contradicts your self-care

  • Low motivation to keep up with diabetes self management

    
    

How common is it?

Diabetes distress is real and measurable with validated screening and diagnostic tools to evaluate for the presence and the severity of symptoms. Overall, a quarter of people living with diabetes report high diabetes distress levels. Additionally, around 1 in 5 people with Type 1 Diabetes or insulin-treated Type 2 Diabetes experience severe distress.

Why does it matter?

In addition to higher diabetes distress causing emotional and psychological stress and symptoms, it often means poorer self-care, elevated A1C, more frequent hypoglycemia, and reduced well-being.

How I can help support you with Diabetes Distress

·       I ask about diabetes distress at every visit

This invites you to share how diabetes feels for you personally—its emotional impact and daily life struggles.  Addressing distress proactively helps prevent deterioration or escalation into depression and leads to better overall outcomes.

·       I normalize feelings

Asking often about diabetes distress normalizes the distress and presents an open platform for you to discuss your feelings. I remind you that distress is a common, expected response and NOT a personal failure! Distress interferes with your ability to manage diabetes effectively through no fault of your own and we partner together to work through it.  

·       We collaborate on your care plan together

We will discuss both clinical tasks and emotional concerns, allocating time intentionally for each area of your health. We will work toward a shared medical plan and realistic goals that align with your current limitations, needs, and abilities. What that means: we will set small attainable yet meaningful medical and emotional goals that match where YOU are in your journey right now. We will also discuss additional resources that may support you, including diabetes education, mental health providers, or support groups.

Take home message:

Diabetes distress is not just normal stress—it’s a specific, measurable emotional response to living with diabetes. As your diabetes management partner, I ask about and screen for distress regularly, normalize the experience, and build collaborative care plans that balance emotional health with clinical goals. Helping you address distress head‑on empowers better diabetes self‑management and enhances well‑being.

Have more questions about diabetes distress? I am here to help—let’s connect on a free educational consultation to discuss further!

Access the Diabetes Distress Handout for even more information here or find a diabetes mental health provider near you!

Disclaimer:

The content on this blog is for informational purposes only and is not intended to provide medical diagnosis, treatment, or replace professional medical advice, diagnosis, or care. Always consult a qualified healthcare provider with any questions regarding a medical condition or treatment.