Diabetes Type 1 And Mental Health

What is diabetes type 1?

Type 1 diabetes is an autoimmune disease, wherein the amount of glucose (sugar) in the blood is abnormally high. It occurs when your body is unable to produce enough insulin, a hormone that regulates blood glucose. This occurs as a result of your body attacking the insulin-producing cells in your pancreas, which prevents you from producing insulin. To keep your blood glucose levels under control, you must take insulin each day. According to the CDC, about 5–10% of patients with diabetes have type 1, which is less common than type 2. Symptoms of type 1 diabetes include feeling extreme thirst, peeing more frequently than usual, weight loss, blurred vision, feeling tired, itching around the vagina or penis or thrush episodes, and cuts that heal frequently.¹ Diabetes-related ketoacidosis (DKA), a potentially fatal condition, develops without insulin. 

Management of diabetes and mental health

It has been shown that people diagnosed with type 1 diabetes are at a higher risk for mental health issues such as depression, anxiety (e.g health anxiety or generalised anxiety disorder), eating problems, and diabetes distress.² This is normal and expected when dealing with a debilitating disorder like diabetes. Therefore it is important to pay attention to your feelings and mental health just as much as your physical health. 

Many of these mental health disorders are treatable and there is a wide range of people you can talk to such as diabetes care teams, doctors, psychologists, counsellors, social workers, and helplines such as Diabetes UK. 

It is also normal to feel a range of different emotions too. It is common to feel denial about your diagnosis and refuse to believe what you have been told about your health. According to a recent study from Diabetes UK, one in five persons with diabetes seeks professional counselling to help them manage their condition.³

Health anxiety

Anxiety includes feelings of distress, worry, and fear. People with diabetes may worry about a variety of issues such as weight, low blood sugar levels, and diet. People with type 1 diabetes are at a higher risk for particular diseases and conditions such as heart disease, glaucoma, blindness, stroke, and kidney disease. This means these patients can have even more health anxiety due to the wear of developing one of these health conditions. 

The findings of a meta-analysis support the idea that anxiety disorders and heightened anxiety symptoms are more likely to occur in people with type 1 diabetes.⁴ Anxiety is 20% more common among diabetics than among non-diabetics at some time in their lives.⁵ 

Hypoglycemia (low blood sugar) can feel like anxiety and vice versa. It could be challenging for you to identify which one it is and efficiently manage it. If you're feeling anxious, it can be worthwhile to check your blood sugar levels; if it is low, seek treatment from your doctor.

Social anxiety

Social anxiety is fear of having these diabetic complications in public. Both increased anxiety symptoms and anxiety disorders are correlated with diabetes. People with type 1 diabetes may experience social anxiety by having to take their medication in front of people or having a hypoglycemic episodes in public.

Depression

Depression is defined as a persistently low mood that lasts for several weeks or months and is characterised by feelings of unhappiness and lack of pleasure in activities (anhedonia). About twice as often as would be predicted by chance alone, diabetes and depression co-occur.⁶ Diabetes and depression co-occurring present a significant clinical problem because each condition worsens the other's impact. Both conditions may be driven by shared underlying behaviors and symptoms such as sleep problems, poor dietary habits, and inflammation.

Eating Disorders

There is a strong relationship between diabetes and food. Due to patients with type 1 diabetes having to focus more on their diet, it is common for them to develop problems with their eating or disordered eating.⁷ According to research, women with Type 1 diabetes mellitus (T1DM) are nearly 2.5 times more likely to experience an eating disorder than women without T1DM. Although there are a number of well-known risk factors for eating disorders, it is unknown why girls and women with Type 1 diabetes have higher rates of disordered eating habits and eating disorders that have been identified.⁸ 

If you’re worried about your or your loved one’s mental health

Mind - 0300 123 3393 (Infoline) - Mind is a charity that offers support and advice to those with mental health problems.

Anxiety UK  - 03444 775 774 (helpline) or 07537 416 905 (text) - This charity provides support and advice for anyone who is suffering from anxiety.

NHS Improving Access to Psychological Therapies (IAPT) - nhs.uk/service-search/find-a-psychological-therapies-service - The NHS provides counselling and therapy services. You are able to self-refer to these services if needed. Please note that this service is only available in England.

Samaritans - 116 123 (freephone) - A charity which provides emotional support for those who are struggling to cope, having suicidal thoughts or are feeling distressed.

You should see a doctor if you:

• Have symptoms of depression and anxiety that are not improving.
• Find your mood affects your work, relationships with your family and friends, and everyday life.
• Have thoughts of suicide or self-harm.

Conclusion

Type 1 diabetes is an autoimmune disease where the amount of glucose (sugar) in the blood is too high. People who have type 1 diabetes are more likely to experience mental health problems, such as sadness, anxiety, and disordered eating. These conditions can be treated;hence it is important to pay attention to how you feel about having diabetes and also support other diabetics in your social circle.