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How can you look after your mental health with diabetes?

Managing diabetes can be overwhelming and complex, leading to emotional distress for many people, but there are ways of improving your emotional health write NELINE GOOSEN and JANICE POWELL.

With all the activities, skills and knowledge required to manage diabetes, it is not surprising that the condition can negatively impact emotional wellbeing and quality of life. One in three people living with diabetes experience impaired emotional wellbeing, and one in five experience diabetes distress.

Diabetes distress is a term used to describe the emotional toll of 24 living with diabetes – the relentless burden of daily self-management and the prospect of long-term health complications. Diabetes distress can present itself as anxiety, depression, diabetes burnout, diabetes-specific fears and eating problems or eating disorders. It is important not to ignore these if they start to present.

Why is diabetes distress so common? The American Association of Diabetes Educators (AADE) has identified seven critical self-care behaviours for optimal health and effective management of diabetes. These include problem solving, reducing risk, monitoring (for example, checking blood glucose levels), taking medication, healthy eating, being active and healthy coping. Although these steps might appear relatively straightforward, statistics reflect how challenging it can be to manage diabetes.

According to an Australian Government audit in 2021, only 18.3% of people with type 1 diabetes and 27.4% of people living with type 2 diabetes in a national audit met the HbA1c target of < 7%. Living with diabetes is demanding and self-management is complex. If you have ever felt overwhelmed with managing diabetes, you are not alone! That is why it is important to ask yourself, “how are you?”

Diabetes is a condition that requires attention 24 hours a day, 365 days of the year. Too often, people feel they are dealing with it alone.

Healthy coping is at the centre of the AADE7 framework because this behaviour is essential if the other six self-care behaviours are to follow. To help cope with the continual demands of self-management, it is important to be equipped with a toolkit of knowledge and skills to help you cope and to be aware of the tell-tale signs of not coping.

Problem solving is a learned behaviour and it is essential for successful selfcare management because it is needed to overcome barriers. At its most basic level, problem solving should identify what the problem is, how to address the problem with strategies, and then select, implement, and evaluate the success of the strategies selected. Effective problem solving can increase a person’s self-confidence in their ability to handle future challenges.

Problem solving can also be used to help you set goals. Goal setting is a useful strategy to help you cope because it provides a sense of purpose and increases positive solution-based thinking. Diabetes distress may be reduced if you focus on specific, measurable, achievable, realistic, and timely goals. Coping strategies can be quite personal and different from person to person. One common concern for many people living with diabetes is the lack of understanding and acknowledgment from others about how difficult self-management can be.

Diabetes is a condition that requires attention 24 hours a day, 365 days of the year. Too often, people feel they are dealing with it alone. This may be a reason why many people living with diabetes have found it so helpful to socialise with others who understand diabetes management. Social support networks not only help with emotional coping through someone providing empathetic listening, encouragement, and acknowledgment of the impact of diabetes, but also provide an opportunity to learn about valuable resources and practical tips from others with similar experiences.

Observing and learning from others also helps to reinforce certain behaviours and the importance of these behaviours. Being motivated, supported, and seeing peers model the behaviours of self-management can be very useful for healthy coping when dealing with a long-term condition such as diabetes. Now that you know the importance of healthy coping, and how common diabetes distress and impaired emotional well-being can be, how are you really?

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