How to deal with the overwhelm around diagnosis
Carolien Koreneff, CDE-RN
A diabetes diagnosis often comes as a profound shock and can evoke a range of emotions, including disbelief, sadness, anger, and self-blame. While these feelings typically diminish as clients adapt to life with diabetes, some individuals continue to struggle with these overwhelming emotions.
As healthcare professionals, we need to consider how best to support our clients in coping with the emotional challenges.
Diabetes and emotional health
Managing diabetes is demanding, complex, costly and time consuming. People with diabetes are required to eat healthy, do regular physical activity, take medications, check their glucose levels and attend medical appointments, among other responsibilities. Effective management requires them to have a good understanding of diabetes, problem-solving skills, the ability to reduce risks, and effective coping strategies.
It is therefore unsurprising that the complexity of diabetes also takes a toll on the emotional well-being and overall quality of life for those living with the condition. Emotional and mental health problems are common for people living with diabetes an are often linked to suboptimal self-management, reduced quality of life, and an increased risk of complications and healthcare costs.
Diabetes-related mental health concerns to look out for often fall into three main categories:
- Negative emotions which encompass a broad spectrum of feelings, including sadness, anger, guilt, and fear
- Diabetes burnout which involves emotional exhaustion and frustration resulting from the ongoing demands of diabetes management, potentially leading to a temporary disengagement from self-care
- Diabetes distress which involves emotional and psychological burdens associated with the day-to-day challenges of living with diabetes, often resulting in feelings of helplessness, anxiety, and overwhelm.
As a health professional, your role is to provide comprehensive support to individuals with diabetes, addressing not just their medical but also their emotional needs.
‘Mental health support should be part of the treatment of every person with diabetes, and should be equal to glucose support.’
Carolien Koreneff,Credentialled Diabetes Educator
Supporting people with diabetes
When supporting people who live with diabetes, it is essential to not only educate them on the fundamentals of diabetes management but also to help them understand that a range of emotions may be experienced at different times, and this is entirely normal. Acknowledging that these emotions are a natural part of the diabetes journey, even if they can be uncomfortable, is a crucial step.
Encourage individuals with diabetes to accept that their current reality involves living with this condition. Engage them in open conversations about what you can do together to change their perspective or alleviate the impact of diabetes on their lives and if necessary, refer them to appropriate professionals
Individuals living with diabetes can feel recognised and supported when a health professional enquires about the emotional aspects of their condition. They value being offered support to address any psychological issues they may be facing, especially if it’s done in a non-judgmental manner. In a person-centred approach to care, they are willing and active participants in addressing psychological challenges when they feel supported and included in the decision-making process. This holistic approach, addresses both the medical and emotional aspects of diabetes, and contributes to a more comprehensive and effective diabetes management strategy.
Diabetes Management Team
Understanding the support, a diabetes management team can provide can be beneficial for someone newly diagnosed with diabetes. The various healthcare team members are there to help individuals navigate their unique and multidisciplinary diabetes management journey.
The general practitioner (GP) serves as a central figure, overseeing overall health, monitoring diabetes, and coordinating the Annual Cycle of Care. Practice nurses collaborate with GPs to assist patients. Credentialled Diabetes Educators offer invaluable insights into understanding and managing diabetes. Dietitians provide guidance on how food choices impact glucose levels and help individuals devise a healthy eating plan. Exercise physiologists contribute by creating effective exercise plans. Endocrinologists offer expert advice, particularly for those with type 1 diabetes or more complex needs.
Other members of the healthcare team can include podiatrists, optometrists, dentists, audiologists, pharmacists, counsellors, psychologists, or social workers, and at times, specialist doctors like cardiologists, ophthalmologists, or geriatricians, especially as individuals age and face additional health concerns. It’s important to note that not all of these professionals need to be part of the diabetes management team at the same time; they should be added as needed to prevent overwhelming individuals
However, the most critical member of this team is the person with diabetes themselves, as they make the day-to-day decisions that impact their health and well-being. Recognising the collective effort of this support network can empower and reassure those who are newly diagnosed, reminding them that they are not alone in their diabetes journey.
Support and resources
The NDSS (National Diabetes Services Scheme) provides reliable and affordable services and resources to assist individuals with diabetes. They offer self-management information sessions and education programs, available both online and in person through local diabetes organisations. These programs empower participants to make informed decisions and effectively manage their condition
One of these programs is the ‘DESMOND’ (Diabetes Education for the Self-Management of Ongoing and Newly Diagnosed) program. This program recognises that there is no ‘one size fits all’ approach to diabetes management and provides a welcoming, non-judgmental space for participants to plan how they would like to manage their diabetes.
Adopting a healthier lifestyle can be challenging, particularly when undertaken alone. The ‘Living Well’ program offers motivation and support to participants to make and sustain positive changes, promoting a healthier and more active lifestyle. Whether your client is recently diagnosed or has been living with diabetes for some time, ‘Living Well’ allows participants to connect with both peers and diabetes health professionals to ask questions and gain valuable insights and guidance.
Peer support groups are also available, connecting people with similar experiences to share support, encouragement, and knowledge. Peer support can take various forms, from online interactions, including reading blogs and sharing on social media, to face-to-face events that enable them to chat in person.
Factsheets can be a valuable resource for clients, offering clear and concise information that can be accessed and used when required to assist them in understanding their diagnosis. One particularly valuable resource for clients recently diagnosed with diabetes is the NDSS factsheet ‘Adjusting to Life with Diabetes.’ This resource not only provides insight into the emotional journey that often accompanies a diabetes diagnosis, but also offers guidance on maintaining emotional well-being and outlines where they can find support.
Family and friends play an important role in supporting a person new diagnosed, but it can be equally challenging for them. In the early stages, they may struggle with feelings of concern, frustration and confusion while trying to provide the best support. The ‘Caring for Someone with Diabetes (for Family and Friends)’ factsheet is valuable tool for them on how to support their relative or friend with diabetes and emphasises the importance of self-care in the process.
Pregnancy can be an exciting yet challenging journey for a person living with diabetes. The process requires careful planning and intensive day-to-day management. Having a knowledgeable partner can help alleviate stress. Information about how partners can provide support can be found here.
In addition to factsheets the NDSS provides on-demand webinars, translated materials, and telephony support available through the NDSS Helpline at 1800 637 700. To access the full range of NDSS programs and services, simply visit www.ndss.com.au.
However, if you are looking for a good resource, whether for yourself, or to share with a fellow health professional working with adults with type 1 or type 2 diabetes, the ‘Diabetes and Emotional Health Handbook’ is highly recommended. This comprehensive guide is designed to make you feel supported, confident, and well-equipped to engage in conversations about how diabetes affects a person’s emotional well-being. It will assist you in addressing psychological issues within your expertise and provides guidance on when to make referrals to specialist care providers.
Establishing a supportive network of healthcare professionals, family, and friends is an important first step in helping those overwhelmed by their diabetes diagnosis. Directing them to comprehensive resources, providing effective communication tools, and adopting a person-centred approach will further contribute to successful diabetes management, enabling them to lead healthier and happier lives. By addressing both the medical and emotional aspects of diabetes, empowers individuals to face the challenges of their diagnosis with confidence and resilience, ensuring don’t feel alone on this journey.