The Connection Between Diabetes and Mental Health

Courtney Masterson, MHA, RDN/LDN

This presentation will concentrate on the interconnectedness of diabetes and mental health. The connection and cyclic effect that these two topics have on each other is one that is often overlooked in the patterns and treatment of blood sugars. Understanding the effects of stress and poor mental health on blood sugar control is critical in treating students and patients as a whole individual, rather than just the chronic disease that they are burdened with.

Transcript

1. Courtney Masterson, MHA, RDN/LDN Quality Insights: The Connection Between Diabetes and Mental Health
2. Objectives • Discuss mental health and what influences mental health. • Explore the interconnectedness of mental health disorders and diabetes. • Examine the effect of living with diabetes on an individual’s mental health.
3. A Little About Me • I am turning 30 in April • I am a Registered Dietitian • I am a late onset Type 1 diabetic • I have been to 13 countries • I have a very spoiled dog
4. Quality Insights Overview • Non-profit organization focused on improving healthcare quality in the pursuit of better care, smarter spending and healthier people • Strive to be a change agent, partner and integrator of local organizations collaborating to improve care
5. Diabetes in Delaware • Between 2000 and 2017, diabetes prevalence in Delaware increased by 82% among adult populations.1 • Pediatric cases have also been steadily increasing across the country for both Type 1 and Type 2. Type 1 has been increasing by 1.4% while Type 2 is increasing by 7.1% annually between 2002 and 2012.2
6. What is Mental Health? According to the CDC: “Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices.”3
7. What Can Affect Our Mental Health?
8. The Lack of Understanding • “Aren’t you going to go to the bathroom? You cannot just do that!” • “You should be ashamed of yourself.” • “It’s really not that big of a deal. So you had some sugar, it’s not going to kill you!”
9. Diabetes and Mental Illness • People with diabetes are 2 to 3 times more likely than the general population to develop depression.4 • Of those that develop depression, <50% will receive adequate treatment to combat their depression. • They are 20% more likely to experience anxiety at some point in their life. – This is often times associated with the pressures of managing their disease state.
10. What Causes Mental Illness? Source: https://www.verywellmind.com/common-causes-of-depression-1066772
11. Psychological Effects of Diabetes • Diabetes is a 24/7 disease, requiring consistent monitoring and intense drug regimens. • Every visit with a practitioner (not just an endocrinologist) brings up your disease state, and it can feel impossible to escape. • Some providers use scare tactics to motivate compliance. This only adds to patient stress level.
12. Daily Regimen • Wake Up Check blood sugar – Blood sugar level then determines if I eat immediately or wait for fasting acting insulin to bring to a normal range (Injection #1) • Track sugar after eating – If first injection did not fully cover meal, give more insulin to limit time above goal (Injection #2) • Check sugar for lunch – Take third injection • In the afternoon I will go for a walk where I need to carry an alert card as well as sugary snacks in case of severe hypoglycemia • Check sugar for dinner – Take both fast acting to cover meal and long acting for background insulin (Injection #4 & 5)
13. Diabetes and Stress • Living with diabetes causes stress in itself. • Abnormal blood sugars can have physical, emotional, and psychological effects, all resulting in further stress. • The stress that the individual is feeling can then contribute even further to uncontrolled blood glucose levels. Abnormal Blood Sugars Emotional Distress Stress
14. Childhood/Young Adult Stressors • Academics • Home stability • Bullying • “Being different” • Juggling responsibilities • Body dysmorphia
15. Familial Stress • Especially in children, the stress of coping with this disease often extends past the individual living with it. • Parents are forced to be hypervigilant of the child’s diet and medications. This can make events that should be fun into a minefield of complicated decisions. • This need for extra attention to one child can also cause a strain on caring for other children in the family.
16. Complications • People living with diabetes, as well as mental illness, experience: – Nonadherence to medication and self-care – Functional impairment – Risk of complications – Health care costs – Risk of early mortality
17. Personal Example
18. In Comparison
19. Coping Mechanisms
20. What Can You Do? • Acknowledge the burden • Offer support • Encourage healthy coping mechanisms
21. Citations 1. https://collections.nlm.nih.gov/catalog/nlm:nlmuid- 101739300-pdf 2. https://www.nejm.org/doi/full/10.1056/NEJMoa1610187 3. https://www.cdc.gov/mentalhealth/learn/index.htm 4. https://www.cdc.gov/diabetes/managing/mental- health.html
22. Thank You This publication was supported by the Cooperative Agreement Number NU58DP006516 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. Publication number DEDPH-HD-012622A