Psychological concerns of Diabetes

 

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“You cannot stop the birds of sorrow from flying over your head — but you can stop them from building a nest there.” (Chinese saying). When someone develops a long-term illness, the situation for the whole family is always a difficult one. There are people who come to a standstill in their grief and are unable to move on. Such people will need professional help. Continuing denial inhibits people from absorbing knowledge and adjusting life to accommodate diabetes (DR. Ragnar Hanas, MD).

Semantic Scholar

Most people go through the same stages when faced with crisis (the onset of Diabetes has proved to be no exception). Professor Johnny Ludvigsson describes the different phases of crisis: Shock phase (difficult to think clearly, thoughts will be whirling around in your head, everything seems unreal, failing to take in information, you listen out for hope, consolation, belief in the future, but shut out all details of the disease); Reaction phase (feeling sorrow, bitterness and disappointment); Repair phase (the worst part is over, you need knowledge that includes learning more about insulin, testing, diet and hypoglycaemia. Systematically, a little bit at a time, you can absorb facts and start to rebuild your life); Reorientation phase (a different but acceptable lifestyle is established -one where diabetes is an important part but by no means everything, Life will never be the same again but it can still be exciting and enjoyable even if some of the rules have changed).

Any person, be they child or adult, who has diabetes needs a coach to motivate them, assess their abilities and potential and adjust their diabetes training on a continuous basis. Let the young person know that you recognize just how difficult things are — often it is much more difficult for children or teenagers to manage life with diabetes well than it would be for their parents to give up smoking, for example. It is far too easy to be overprotective of children with diabetes. Sympathy is fine but pity is less helpful. As was suggested by the Chinese philosophy “Try to see your diabetes as a part of yourself which can melt into balance and harmony with the rest of your personality. Your attitude is a very important part of diabetes treatment. Those who hate their illness will soon begin fighting against it”.

Diabetes Research & Wellness Foundation

There are three common ways in which people view their diabetes:

1.       Ignoring it, eating what they like and only taking enough insulin to avoid feeling bad at that moment (If you have this attitude when you enter adulthood, there is a risk that you will never be able to change it).

2.       Becoming absorbed and obsessed by diabetes, living only to take care of the illness as effectively as possible (if the efforts to obtain a perfect glucose level prevent a person from enjoying social activities, parties, being with friends or staying overnight with friends or at camps, things have gone too far). If this applies to you, it is high time to give yourself a break and allow yourself to start living life again.

3.       Making diabetes a natural part of everyday life (it is possible to accept your illness without letting it take control of your life completely). If taking insulin becomes like brushing your teeth, something you do daily without really thinking about it but that you would absolutely not want to be without, then you have come a long way.

Family and friends must be sufficiently knowledgeable about diabetes if they are to offer any help or understanding. At the same time a child, a teenager or a partner must understand how much those closest to them need to know about their everyday life, for them to feel secure and confident. Treatment of hypoglycaemia (low blood glucose level) is an obvious example, and it would be useful if they could also give an injection of glucagon. The more your friends know, the more help you will be able to receive from them. Try to explain what you are doing and why. Explain how insulin works, how exercise works, why sometimes you can eat sugar and sometimes you can’t.

IDF 2020 World Diabetes Theme

DR. Ragnar Hanas (2019) suggested that, it is evident that you have not accepted your diabetes if you do not want to tell your friends. It is important your friends understand why you might be feeling unwell, and what they can do about it. A “family council”, where you put aside time to sit down together, can be an ideal forum to discuss how to come to agreement on different subjects within the family.

The following responses are from patients with well lived experiences of Diabetes to help inspire &/encourage someone in the same journey of fighting against a lifetime chronic condition:

I didn’t think much about diabetes at the beginning…. I could say there were no emotions at all. I remember regaining my consciousness and my mother telling me I had diabetes. The easiest way she described it was telling me I couldn’t take sugar anymore. I never bothered reading about it or asking any questions!!!!! I just followed whatever the doctor said after that. I could say I’m managing type 1 diabetes better than I did 3 years ago. Being part of Africa Diabetes Alliance has greatly helped me improve my management. Sharing with other T1Ds and learning from their experiences, the nutritional education I have learnt from Edith (Nutritionist), the diabetes education I have gotten from the IDF Young leaders in diabetes program. With all this information and support, I have managed to make better choices. I actually eat pretty much what everyone in my family eats… I just avoid certain foods with lots of carbs and watch my food portions as well. I have also made it a point to educate anyone that has immediate contact with me on ways to help me should I get a diabetes emergency. Even my 6-year-old cousin knows what to do when my blood glucose levels are dangerously low and she never takes any of the sugary products I keep in case of an emergency. I think it’s very important to educate your loved ones on ways to best support you as a diabetic. @SarahBiyinzika  (Type1diabetic)

I saw diabetes from the beginning as something manageable and curable. I am on autopilot with diabetes. All close friends know and eat what I eat. Because I mainly eat non starchy fresh vegetables, it is a very healthy diet, anyone around me is happy to follow. Close people around me are curious about how well I manage my diabetes. Although many are non-diabetic, I share a lot with them and they know my situation well. This empowers them to support me too. @JuliaJoseph  (Type1diabetic)

I only know diabetes. I have no memory of not being diabetic. Subsequently I don’t really have any coping mechanisms etc. – this is just the way it is. Generally speaking, my family share the same diet as I do. On occasion if I have high blood sugar, I will forgo dinner while my family eats. I find it imperative for a family and close friends to be aware of hypo symptoms and how to assist me. I have you my diabetes simply as part of my life. I view my medication etc. As the tools that help me to live. I do find in the online forums that diabetics diagnosed later in life seem to experience a large amount of depression and anxiety about maintaining the disease. I often view it as a blessing that I know nothing else. @Josh (Type1diabetic)

First days, l didn't care much because l was about to write my Ordinary Level Examinations and concentrated on my studies. Then after exams, it then sank into my mind that l will be like this for the rest of my life & l would cry & cry until l accepted & started reading about how to care of my "new" self. I share the same menu with my family but adjusted how we cook & what we buy. e.g. little oil, buy bread brown etc. then l have my own separate snacks. At first they were not knowledgeable but now they know hypo signs & what to do, eating timetable etc. @RufaroGororo  (Type1diabetic)

Diabetes is an invisible handicap, and cannot be seen from the outside. You may sometimes feel better if nobody knows. However, your family and your friends will find it easier in the long run if you let everyone know. If, for instance, you become hypoglycaemic, everyone will understand what is going on and what to do if you have informed them beforehand.  

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