Diabetes Care Community

Tag: Stress

  • Frustration with diabetes management

    Frustration with diabetes management

    [vc_row][vc_column][vc_column_text css=””]Have you ever felt like you are on an emotional roller coaster when you see your blood glucose (sugar) readings going up and down with no clear explanation? Have you experienced times when no matter what you do, you cannot seem to get off the roller coaster? If the answer is yes, please be assured that you are not alone![/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]Variability in blood sugar is a continuing source of annoyance for people with diabetes, sometimes driving them to stop checking it. However, blood sugar variability can lead to many complications. So, before you admit defeat, let’s investigate how you can deal with this frustration in a more positive way.

    The first step is to understand why there is variability in your blood sugar values. With this knowledge you can better reflect on what factors can affect your readings. The second step is setting realistic goals. The third step involves investigating more helpful self-talk. Since frustration is a self-generated response, you need to practice self-compassion.

    What affects blood sugar?

    You have likely been taught that the food you eat, the activity you engage in and the medications you take can all affect your blood sugar. These are the obvious culprits, but have you considered other factors, such as pain, dehydration, altitude, anxiety, hormonal changes, sleep habits and stress? As Adam Brown states in his book “Bright Spots and Landmines,” there are at least 42 factors that can affect your blood sugar. The suggestion is that you need to be your own detective. Take some time to accurately record your food intake, activities and emotions, as well as your blood sugar readings. Repeat these recordings on different days of the week. Do you notice any patterns? Are there any particular foods or certain activities that affect your blood sugar, either in a positive or negative direction? What does stress do to your readings? Are your levels improved with a good night’s sleep? Awareness is knowledge that you can work with.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]To help explain blood sugar excursions, it’s a good idea to familiarize yourself with some of the excellent tools available. Understanding food labels and mastering the handy portion guide for portion control are beneficial techniques for deciphering information about food and portion sizes.Bottom of Form There are so many additives to foods that may be affecting your blood sugars. Also keep in mind that aerobic exercise versus resistance exercise can have different effects on your blood sugar. The current technology for measuring physical activity can provide a wealth of information to help us interpret our blood sugar levels.[/vc_column_text][read-also-article article-slug=”exercise-and-blood-sugar-control/”][vc_column_text css=””]

    Setting realistic targets

    Armed with the knowledge you now have as to what affects your blood sugar, your next questions are: “What target values are realistic for me to work towards?” “How much blood sugar variability is okay, and when should I be concerned?”

    Regardless of the method you are using to measure your blood sugar, the targets for most people with diabetes are 4 to 7 mmol/L before meals and 5 to 10 mmol/L 2 hours after meals (or 5 to 8 mmol/L if your A1C target is not being met). These values equate to an A1C of 7% and a >70% time in range.

    If you are using intermittent or continuous glucose monitoring systems, your downloads will have a measurement of the % of time in range, % of glycemic variability and standard deviation. Speak with your diabetes healthcare team about your appropriate targets.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont3′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]Since diabetes is a very personal condition, all of your blood sugar targets need to be individualized to your life and your needs. Age, medications (especially steroid use) and comorbid conditions such as heart failure or kidney disease, will all factor into your and your healthcare team’s decision regarding the best target range for you to aim for.

    Once you have set up a realistic target range for your blood sugar levels you need to work with your expectations. Your goal here is to manage your blood sugar, not strive for perfection. Even people without diabetes see fluctuations in their blood sugar. You too will see these fluctuations despite your best efforts. Many people with diabetes see this as a failure. Feelings of guilt and self blame may surface, creating endless frustration. You deal with this by realizing that you can control some things, but many other factors are outside of your control. That’s why it’s important to engage in the act of self-compassion.[/vc_column_text][read-also-article article-slug=”blood-glucose-level-fluctuations/”][vc_column_text css=””]

    Engaging in self-compassion

    In simple terms, self-compassion is the ability to be kind to ourselves. Kristin Neff, a psychologist known for pioneering research on self-compassion, has suggested that there are 3 components to self-compassion: self-kindness versus judgment, common humanity versus isolation and mindfulness versus over-identification.

    Applying this principle directly to your frustration with ‘imperfect’ blood sugar readings, you need to initially stop judging yourself by the numbers you see. By gearing your self-talk to the positive aspect rather than centering on the negative, you aim to see the trend to improvement. Rather than dwelling on the high number, you can look at the trend, and use your investigative skills to continue in the positive direction.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””][ad-slot slotcode=’div-gpt-ad-lb-resp-cont4′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]You also need to remember that you live in the real world. Your human instincts direct you towards pleasure, and you will occasionally eat that chocolate bar or that fabulous piece of chocolate cake. This is not failure but simply being human. One high reading does not alter your A1C nor dramatically change your time in range. Allow yourself to deal with your diabetes in the context of real life.

    By living in the present and recognizing that your blood sugar readings do not define you, it is easier to develop a healthier mindset. By engaging in positive self-talk and self-encouragement with more realistic goals, you can decrease the frustration you have previously felt. Utilize your expertise and abilities in diabetes care to continually pursue enhancement, while acknowledging that perfection is an unattainable standard for any individual.

    You can take yourself off the roller coaster![/vc_column_text][read-also-article article-slug=”build-resilience-by-navigating-your-diabetes-with-a-growth-mindset/”][/vc_column][/vc_row]

  • Emotional support for type 2 diabetes

    Emotional support for type 2 diabetes

    [vc_row][vc_column][vc_column_text css=””]Stress from our generally busy lifestyles can worsen the condition for people with type 2 diabetes. Add to lifestyle stress, the added stressors of struggling to meet diabetes management targets and often the related costs, and it is not surprising that many people end up with the diabetes ‘blues’. Emotional support for type 2 diabetes is available – it’s just a matter of knowing where to find it. Stress is also an ongoing challenge for many people who are supporting others with diabetes.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]

    The facts:

    When faced with a stressful situation beyond our control, the brain releases two hormones: cortisol and adrenalin. These hormones raise blood sugar levels to help increase our energy so we can respond to danger or a life-threatening situation. This allows us to engage in our fight-or-flight response. When the brain is continually bombarded with stressful situations, it begins to pump out these hormones in excess, putting our bodies at increased risk of illness. To curb the increase in blood sugar levels, people with diabetes and their caregivers need to understand the early signs and learn coping strategies to manage the stressors.

    Stress after a diagnosis of type 2 diabetes:

    For many individuals, a diagnosis of type 2 diabetes comes completely out of the blue, adding shock and disbelief to a rollercoaster of other feelings. Be prepared for the fact that multiple emotional stages may be experienced, including a shift backwards and forwards between different moods.Emotions may include:

    • Shock & disbelief
    • Denial
    • Anger
    • Grief
    • Feelings of being overwhelmed
    • Fear & anxiety
    • Numbness & disorientation
    • Depression
    • Guilt

    Know what you are dealing with. The more educated you become, the easier your journey with diabetes will be. Understanding the condition, its progression, and management strategies can reduce feelings of helplessness. You will also find a wealth of information on this site.[/vc_column_text][read-also-article article-slug=”diabetes-distress”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]

    Getting support

    Psychological counselling and therapy

    Professional counselling can provide a safe space for individuals to express their fears and frustrations. Cognitive-behavioral therapy (CBT) has been shown to be particularly effective in managing diabetes-related distress and depression. CBT helps individuals reframe negative thoughts and develop coping strategies to deal with the emotional burden of diabetes.

    Support groups and peer networks

    Support groups offer a platform for individuals to share experiences, challenges, and successes. Connecting with others who face similar struggles can reduce feelings of isolation and provide practical advice and emotional encouragement. Peer support can be facilitated through in-person meetings, online forums, or social media groups.

    Family and friends

    Involving family and friends in diabetes management can provide essential emotional support. Educating loved ones about the challenges of diabetes and how they can help can foster a supportive environment. Encouraging open communication about the emotional aspects of living with diabetes can strengthen relationships and provide a network of support.

    Mindfulness and stress management

    Mindfulness practices such as meditation, yoga, and deep-breathing exercises can help manage stress and improve emotional well-being. These practices encourage a focus on the present moment, reducing anxiety about future complications and fostering a sense of calm and balance.

    Holistic health approaches

    Adopting a holistic approach to health that includes physical, emotional, and mental well-being is crucial. Regular physical activity not only helps control blood sugar levels but also releases endorphins that improve mood. A balanced diet that includes enjoyable foods can reduce the feeling of deprivation and improve overall satisfaction with life.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont3′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css=””]Developing resilience is key to coping with the emotional challenges of type 2 diabetes. Encouraging individuals to set realistic goals and celebrate small victories can build confidence and a positive outlook. Highlighting success stories and providing role models who have effectively managed their diabetes can inspire hope and motivate individuals to persist in their self-care efforts.

    Emotional support for individuals with type 2 diabetes is as crucial as medical management. Addressing the psychological, social, and emotional aspects of diabetes can significantly enhance the quality of life and improve health outcomes. For more information, check out our Emotional Well-Being resources.[/vc_column_text][read-also-article article-slug=”how-emotional-well-being-impacts-diabetes-management”][/vc_column][/vc_row]

  • How emotional well-being impacts diabetes management

    How emotional well-being impacts diabetes management

    [vc_row][vc_column][vc_column_text]Diabetes is a unique condition as the burden of management is placed mainly on you, the person living with diabetes. For other chronic health conditions, a physician or other healthcare team member prescribes medications and intermittently monitors progress. In contrast, people living with diabetes are expected to identify and understand the many factors that affect blood sugar levels, adjust for these on a daily basis, and respond and react to their own data. If you are living with diabetes, you are expected to adjust your nutrition and physical activity. If you are using insulin, you are expected to determine and adjust your insulin doses based on your blood sugars and the food you are eating.

    The demands on people living with diabetes have perhaps increased even more in recent years with the growing use of continuous glucose monitors, which have a number of important benefits but could also lead to data overload.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Can emotional well-being affect blood sugars?

    More than 40 factors are known to affect blood sugars. Stress and inadequate sleep directly raise blood sugars by increasing levels of stress hormones. However, emotional well-being affects blood sugars indirectly through one’s ability to perform the necessary tasks of self-monitoring and self-managing. Given the numerous times per day an individual must think about diabetes and make decisions that will affect their blood sugars, it is not surprising that one’s emotional state affects their ability to perform these tasks. Managing diabetes is a full-time job. Like any other job, it is difficult or impossible to perform well when you are struggling with your emotional well-being.

    If your diabetes seems out of control, it is important to reflect on the causes for this. Although high blood sugars could be due to progression of diabetes and the need for additional medications, a much more common reason is impaired emotional well-being, making it difficult for you to perform the job of managing your diabetes. This can be triggered by disruptions to your usual lifestyle or routines by challenging events, such as the breakdown of a relationship, an illness in a family member, or losing your job. Poor emotional well-being is often associated with a sense of hopelessness or helplessness when it comes to diabetes self-management. This leads to poor choices for nutrition or physical activity, and can progress to avoidance behaviours such as not wanting to monitor blood sugars or forgetting to do so, or neglecting to take diabetes medications.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Set realistic goals

    Checking in with yourself on a regular basis regarding your emotional well-being is helpful, especially when major life changes or disruptions occur. Reflect on how these stressors have affected you, and what impact this is having on your ability to perform your job managing diabetes. Although you may not be able to control external events and stressors, you can control your reaction, awareness and acceptance of these events. This alone can have a positive impact.

    It is important to avoid the pitfall of an ‘all-or-nothing’ mentality when it comes to diabetes self-management. Although there are times you may not be capable of devoting 100% of your usual effort to diabetes management, you can acknowledge and accept this temporary disruption. If you are struggling, setting incremental and realistic goals is helpful. For some, this may mean the initial goal is simply to start monitoring blood sugar levels, without needing to act on the results immediately. Another pitfall to avoid is feeling judged or shamed by the numbers. Your healthcare team wants to meet you where you are at and work with you on making positive changes.[/vc_column_text][read-also-article article-slug=”action-plan-to-deal-with-diabetes-distress/”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Develop positive coping strategies

    When I am seeing a patient who is struggling or is very anxious or distressed by their diabetes, there are 2 questions I like to explore. First, I ask the patient how overwhelmed they are currently feeling with the demands of living with diabetes. When someone is feeling highly overwhelmed, the next step is to discuss what specifically they are finding most overwhelming so we can work on developing some strategies around this. Second, I ask patients how often they feel they are failing with their diabetes routine. If this is occurring often, the next step is to explore what they specifically feel they are failing at so we can develop positive strategies to improve these distressing feelings.[/vc_column_text][read-also-article article-slug=”fostering-positive-emotion-how-to-live-life-more-fully/”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont3′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Succeeding at your job as your diabetes manager requires strong emotional well-being. Fortunately, emotional well-being is a skill that can be practiced and improved, and therefore requires the same level of self-monitoring and self-reflection as blood sugar values.

    Tips for emotional well-being

    • If your diabetes seems out of control, reflect on how your emotional well-being could be contributing to your ability to perform your job managing diabetes.
    • Avoid an all-or-nothing mentality when it comes to managing diabetes. Instead, set incremental and realistic goals.
    • Separate your emotions from the numbers. Your self-worth is not defined by your blood sugar values.

    [/vc_column_text][read-also-article article-slug=”emotional-well-being-an-essential-pillar-of-diabetes-self-care/”][/vc_column][/vc_row]

  • Action plan to deal with diabetes distress

    Action plan to deal with diabetes distress

    [vc_row][vc_column][vc_column_text]AUTHOR: Gail MacNeil RN, CDE

    REVIEWED BY: Dr. Barry Simon, MD, FRCP, Psychiatrist and Psychoanalyst[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Diabetes distress is your emotional response to living with diabetes. It is normal to experience some stress, but when the level of stress becomes overwhelming it can significantly undermine your confidence and ability to take care of the daily tasks required for your diabetes management.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]In our previous article, we shared the link to the Diabetes Distress Survey. Completing this survey is the first step in identifying not only the level of your anxiety, but also the specific areas that are causing you the highest levels of stress.[/vc_column_text][read-also-article article-slug=”diabetes-distress/”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    Diabetes distress: type 1 and type 2 diabetes

    Researchers have noted some differences between people with type 1 and type 2 diabetes regarding specific areas of stress. Studies show that, in type 1 diabetes, the most common distress relates to emotions, such as feelings of powerlessness and burnout, fear of hypoglycemia and worry about the future. In type 2 diabetes, stress often relates to managing the condition, guilt about having diabetes and concerns regarding the development of complications. Results from the screening tools also identify that the “patient-provider relationship” is a common area of stress for most people with diabetes.

    A very important part of completing and interpreting this survey is to help you identify how your emotions can be directing your behaviour. With this reflection, you can begin work on your specific interventions. The next time you meet with your healthcare team, a great place to start the conversation regarding your mental health is by sharing your survey results.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    How you can interpret your diabetes distress survey results

    To start, what is your total score? If it is less than 2, your stress level is under control, and you are encouraged to continue with the management plan that is working well for you. Total scores from 2.0 to 2.9 are considered ‘moderate stress’ and scores of 3 or higher are classified as ‘high stress.’ These scores indicate that your emotional response is having a significant impact on your ability to deal with the daily demands of diabetes. Do not interpret higher scores as a failure but rather as a call to action!

    There are four domains, or subscales, that can help you identify the areas where you are experiencing the highest levels of stress. Each of these areas is potentially problematic and you can experience varying degrees of distress in each domain. The more specific you can be in what is contributing to your level of stress, the more directive you can be in your interventions.

    1. Emotional distress refers to your fears regarding the complications of diabetes and how much energy it takes to do the daily tasks necessary to manage your diabetes. Emotional distress can be much more exhausting than the work required to take care of diabetes.
    2. Physician distress describes your concern with your relationship with your physician or healthcare team. It may be that you feel they do not understand what it is like for you to live with diabetes or that they do not answer your questions or give you practical advice.
    3. With regimen distress, you have feelings of discouragement and frustration about keeping up with the specific demands of your medication regimen, blood glucose monitoring, healthy eating and exercise, all important components of the daily program you have set up for yourself.
    4. Diabetes is a family affair. Relationships can become very stressful when you have expectations of how you would like to be supported, but your family either does not share your concerns or tries to control your diabetes management. This is known as interpersonal distress.

    When reviewing your results, where is your highest area of stress? Reflect upon how you answered the questions in that area. What is causing you the most anxiety?[/vc_column_text][read-also-article article-slug=”diabetes-distress-share-your-feelings-with-your-healthcare-team”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    What can I do about diabetes distress?

    Once you have identified the diabetes distress areas that are causing you the highest level of stress, you can begin to work towards reducing it. Diabetes distress is caused by two different issues: the first is that your diabetes knowledge may be a bit rusty and an opportunity to review your diabetes education eases your distress. The second involves negative thinking about living with diabetes. In this latter group, learning to cope better with the stress, burden and negative thinking that come with taking care of diabetes is key. Let’s look at each group separately.

    Diabetes distress: time for a knowledge reboot

    Many people have distress because they aren’t sure how to cope with high blood sugars, how to deal with low blood sugars overnight or how to count carbohydrates, for example. All of these are ‘how to’ problems that lead to diabetes distress. If you feel alone with this task, it is not surprising that you will be annoyed with your healthcare team or your family. So, for some people, the recovery from diabetes distress is a knowledge game.

    In this group, you have one goal: define the specific issue that triggers distress. It is more helpful to say ‘I am very distressed by my fasting blood sugars’ than saying ‘my blood sugar readings stress me out.’ If you are in the “know how” group you will typically score high on regimen or physician distress. You may feel alone with your diabetes, but the real issue is that you are alone without sufficient knowledge.

    If you are in this group, seek out reliable knowledge or see if you can book a time with your diabetes educator. The first step is to be very specific and ask yourself, “When am I specifically very confident about my diabetes care?” Let the results help you be specific. If you have high morning blood sugars, the problem may be your overnight control. Consider strategies for improving overnight blood sugar. The steps are beyond this article, but by being specific and identifying what you are distressed about, you can begin to problem-solve the issue. Create a smart goal – a specific, measurable plan for dealing with overnight highs and making changes. Be realistic in your expectations and realize that you can make other changes until you get a reasonable result.

    Diabetes distress: your negative self-talk is leading to burnout

    For other people, the problem is emotional distress caused by taking care of diabetes. If you are in this group, you know what to do but the act of doing it causes you a lot of distress. You may even have a very good A1C, but you are experiencing a lot of negative self-talk. The diagram below helps you understand this issue.[/vc_column_text][vc_single_image image=”36814″ img_size=”full”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]This situation is a specific diabetes care moment. Your ‘inner reaction’ is the thoughts or images you have about the situation. If your inner reaction is causing the distress, read on. Ask yourself, “Am I engaging in negative self-talk?” The negative self-talk is your automatic reaction to the situation. Most people don’t have perfect blood sugars, but if you have expectations of perfection a high blood sugar triggers distress.

    Case study: Jayne

    When Jayne started to explore her feelings, she realized that before she even started to check her blood sugar she was engaged in negative self-talk: “The numbers are going to be high, the day will be ruined, so I might as well give up.” Those series of thoughts trigger a great deal of frustration, annoyance and even hopelessness. It is not surprising she is distressed. Diabetes is a demanding illness, so it is not Jayne’s fault; unfortunately, only she can fix it.

    Jayne always assumed she was doing something wrong if she had a high blood sugar. This negative self-talk leads to anger, guilt and shame and may even lead her to give up on her diabetes care. Jayne may test less often, not because she doesn’t know what to do if it is high, but because she wants to avoid the negative emotional response of high blood sugars.

    [/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont3′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

    How to ease negative self-talk

    What would happen if you focused on changing your expectations and your thoughts, not your care? For example, not all of Jayne’s blood glucose readings are high. If she could shift her focus to the blood glucose readings that are in target and congratulate herself when this happens, she will develop a more positive feeling associated toward her blood glucose testing. She can further explore what she did that may have contributed to the lower reading. Jayne also needs to separate herself from the readings and not label herself ‘good’ or ‘bad’ according to the numbers.

    Many factors cause blood sugar readings to vary. Diabetes is a physiological condition that you can never have 100% control over. This is where the healthcare team can help Jayne explore factors she can control and not blame herself or feel guilty for the factors that she cannot control. By changing her expectations and dwelling on the positive, Jayne will find that her confidence will increase.

    To develop new perspectives, find the positive in what you are doing. Talk to yourself about this. Begin to recognize all the times you are doing well. Also, take note of your negative thinking and write it down. Ask yourself two simple questions: What would be a more helpful thought? What would you tell your best friend? The act of recognizing a thought such as: ‘I can’t do anything right’ and re-framing it to ‘most of the time, I am doing OK, I need to be less hard on myself’ will help ease the stress that leads you to need a break.

    Dealing effectively with your stress involves developing new attitudes promoted by your successes, having more realistic expectations and being open to new learning. Technology is showing us new ways to simplify every aspect of diabetes care, but collaboration with your healthcare team is a key to successful management.

    In our next article we will explore this discussion with your healthcare provider. We will also provide you with tips to get the conversation going and some ideas to help ensure you are heading on the right track.

    Great work to date![/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][read-also-article article-slug=”3-tips-for-planning-your-next-healthcare-visit/”][/vc_column][/vc_row]

  • COVID-19 and mental health: where can I turn to for support?

    COVID-19 and mental health: where can I turn to for support?

    [vc_row][vc_column][vc_column_text]All of us have been affected in drastic and unexpected ways by the COVID-19 pandemic and will continue to be for the foreseeable future. At times it can feel like the pandemic will never end, and emotions such as fear, uncertainty and panic can leave us feeling immobilized. For people living with chronic conditions, including diabetes, these emotions are compounded due to the greater risks of COVID-19. The mental health impacts of the pandemic are only worsened by other factors of our lives, including isolation, financial strain and health status. A question many of us have asked is, “How can we protect our mental health during COVID-19 while living with diabetes?” Health and wellness look different for each of us, but there are a number of supports available that can help us ride the waves of this pandemic.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Many people put their physical health needs first, but often neglect their mental health. Research has shown that people living with diabetes are more likely to experience a mental health concern, and rates of mental distress have risen during the pandemic. Now, more than ever, is the time to allow ourselves to focus on our mental health. Mental health counsellors can help you explore negative emotions and thoughts to help you develop more balanced, adaptive ways of thinking and living. For example, research into people with diabetes found that those who engaged in counselling not only improved their mental health, they were also more successful in managing their diabetes. Mental health counselling can feel scary and strange to many of us, but it can be a profound and positive life-changing experience for those who engage in it.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont1′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The availability of mental health services varies across Canada, but with technological advancements counselling is now more accessible than ever. Each province and territory has its own level of public mental health care available. Calling local information resource lines, such as 211 (a free helpline that connects you to community and social services in your area), can help you find what is available in your area. Most private insurers also cover counselling to some degree. If you have insurance, speak with your provider to learn the specifics of your coverage as this can vary widely between insurers. Online resource listings, such as Psychology Today, are a great way to help you find counsellors and therapists in your community that specialize in the areas you are looking for, and are covered by your insurer.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][read-also-article article-slug=”coronavirus-support-meditation-relaxation-and-mental-health/”][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]To further give ourselves peace of mind, receiving a COVID-19 vaccine adds an extra layer of protection for both our physical and mental health. The COVID-19 vaccines have overwhelmingly been proven to be safe, including for people living with diabetes. The vaccines are protective not only against becoming infected, but against hospitalization and death. While we will have to live with the pandemic for some time, receiving a vaccine can reassure us that we are protected from the worst harms of the virus.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text][ad-slot slotcode=’div-gpt-ad-lb-resp-cont2′][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]It is no secret that managing diabetes can be expensive. From purchasing diabetes supplies, to eating healthy foods diabetes can take a toll on our finances, particularly for those with lower incomes. Financial strain of any kind can cause mental distress in a number of ways. However, in Canada, there are public and charitable financial supports available for people living with diabetes. While the level of support varies across provinces and territories, a variety of public and charitable benefits are available. Your healthcare team can provide you with all the details of supports available to you.

    COVID-19’s impacts on us are wide ranging, and one of the most challenging aspects is the lack of control many of us feel in our lives. While we cannot control the pandemic, we can control how we care for ourselves during this time. Ultimately, we cannot care for our physical health unless we also care for our mental health.[/vc_column_text][/vc_column][/vc_row]

  • EXPERTS ANSWER COVID-19 QUESTIONS: Risks, Complications & Stress

    EXPERTS ANSWER COVID-19 QUESTIONS: Risks, Complications & Stress

    [vc_row][vc_column][vc_column_text]In the midst of a pandemic felt the world over, we asked our diabetes community here in Canada to provide us with their most “burning questions” around COVID-19. Your response was overwhelming. So, in an effort to address your COVID-19 concerns as accurately as possible, we assembled a group of leading healthcare experts to tackle your questions.

    In this first of a four-part series, nurse and Certified Diabetes Educator, Gail MacNeil, discusses the risks, complications and stresses associated with COVID-19 with endocrinologist, Dr. Alanna Weisman, and psychiatrist, Dr. Barry Simon. Here are their insights.

    Are people with diabetes at higher risk of getting COVID-19?

     It’s important to note that the research is ongoing, so we’re learning more each day. But from what we know right now, we do not believe that people with diabetes are at higher risk for becoming infected with COVID-19 compared to those without diabetes.

    At this time, we believe the risk of acquiring the infection has more to do with exposure to the virus, which can be mitigated by social distancing, wearing a mask, etc.

    How does COVID-19 impact blood sugar?

    Similar to other illnesses, being infected with COVID-19 can have an effect on blood sugar levels. There have been reports of some patients experiencing low blood sugar (hypoglycemia), which might be the result of not eating as much when you feel ill.

    We’re seeing some patients, especially those sick enough to be admitted to hospital, with severely high blood sugar (hyperglycemia), which requires a massive increase in insulin doses. We’re also seeing diabetic ketoacidosis in infected patients, especially those with type 1 diabetes, where consistently high blood sugar levels cause toxic compounds to build up in the blood and urine.

    It’s very important to monitor your blood sugars more carefully if you have diabetes and become infected to see if you might require a change in your insulin dose.

    What is the risk of complications for people with diabetes infected with COVID-19?

    While there isn’t a greater risk of contracting COVID-19 if you have diabetes, there is a higher risk of a more severe illness if you become infected. This means a greater chance of being hospitalized and needing intensive care support.

    How does stress during COVID-19 impact blood sugar levels?

    Remember that a stress, whether it’s an emotional or physical strain, is something we don’t believe we can cope with.[/vc_column_text][vc_single_image image=”19180″ img_size=”660 x 330″][vc_column_text]One of the problems with COVID-19 is the unknown: not knowing when it’s going to end or if we or our family members are going to get it. It’s a stressor we are all facing, and when we have a stressor, our bodies go into fight or flight mode. As a result, for some patients it is tougher to manage blood sugar levels.

    What are some ways to manage COVID-related stress when you have diabetes?

    We can separate stress into the things we can control and those we can’t. Focusing on the things you can control, or even making a list of these things, will reduce stress and help you gain some sense of control.

    Another simple psychotherapy intervention is to literally label your feelings. Studies have shown that if you put just one word to what you’re feeling (e.g. frustrated), the brain will quiet down. The simple rule is that if you can ‘name it’ (the feeling), you can ‘tame it’.

    Meditation is another great way to calm the mind, and now there are several downloadable apps to help you meditate (e.g. headspace, CALM, insight Timer).[/vc_column_text][vc_single_image image=”19181″ img_size=”660 x 330″][vc_column_text]Also, consider implementing these three Cs to help relieve stress:

    • Connection (reaching out to friends and family to share concerns)
    • Contribution (checking in and helping others takes the focus off yourself)
    • Creativity (finding new things to invest your time in instead of worrying)

    Here are some good apps and websites to help reduce anxiety during COVID[/vc_column_text][vc_column_text]Are there pre-existing complications/risks that can impact the outcome of COVID-19?

    People with obesity and poorly controlled blood sugar levels may have a higher risk of severe COVID-19 symptoms. Making positive lifestyle changes to reduce weight and trying to optimize blood sugar control will help minimize the risk of severe outcomes from COVID-19. These are changes recommended to anyone with diabetes, even outside of COVID-19.

    Just keep in mind that this is not the time for extreme changes. Any dramatic changes to your diet and lifestyle should be discussed with your healthcare team first.

    Is there any difference in risk of COVID-19 for people with type 1 vs type 2 diabetes?

    In addition to the higher risk of diabetic ketoacidosis in people with type 1 diabetes mentioned above, we are hearing about cardiovascular complications in people with type 2 diabetes who are infected. Otherwise the risks are similar for both, namely that the symptoms of COVID-19 will be more severe in people with diabetes, compared to those without.

    Beyond diabetes, age is also a risk factor, as are other underlying conditions such as kidney or cardiovascular disease.

    What is the risk of death due to COVID-19 in people with diabetes?

    There is no data available yet for Canada. What we’ve seen in other countries is that the risk of death is 50-75% higher in people with diabetes compared to those without. But it’s important to remember that the risk of death overall is still quite small.

    Do people with prediabetes face the same risks as those with diabetes?

    Yes, like people with diabetes, they run the risk of having more severe COVID-19 symptoms. There’s also the potential of newly recognized diabetes throughout the course of COVID-19 illness. For those with prediabetes who get COVID-19, it’s important they know how to recognize the symptoms of high blood sugar, such as increased thirst or changes to vision.

    What is support like for non-COVID emergencies now?

    While some elements of healthcare are not happening at the same rate (e.g., elective surgery), primary care physicians and diabetes specialists are readily available, at least for virtual appointments. In fact, we can deal with a lot of concerns virtually and then bring in patients if needed.

    Hospitals and clinics have personal protective equipment readily available and patients shouldn’t be afraid to get seen if they have concerns. You don’t want to a get a more serious illness because you’ve ignored symptoms and delayed care.

    What are the concerns in terms of returning to work?

    It depends on your individual risks (age, other medical conditions, blood sugar control). Then there are the risks of the actual workplace that will vary depending on what the work involves and how many people you will be coming in contact with.

    Diabetes Canada has developed an advocacy letter people can show their employers to help them understand the risks of COVID-19 for people with diabetes. Your healthcare team can also help you advocate for modifications when possible to minimize the risk of exposure. Advocating for yourself is also another way to minimize stress by taking control of the situation.

    What is the risk of working in healthcare for someone living with diabetes?

    It depends on individual risks and making decisions based on your own specific circumstances. Some experts have recommended that people with diabetes working in healthcare should have accommodations to minimize their direct contact with patients if possible.

    How do I overcome my fears around COVID-19, especially when I see people wearing masks on the street?

    Seeing people with masks can be distressing no doubt. But keep in mind that some people are choosing to wear masks because of their own individual circumstances (e.g. living with someone elderly or immune-compromised).

    Find more information on ways to protect yourself during COVID-19 here.[/vc_column_text][vc_column_text]

    How can I keep myself healthy during this pandemic?

    Focus on the things you can control, such as maintaining good blood sugar control, exercising and eating a healthy diet. There are patients whose blood sugar levels have improved during this time because they’re able to spend a lot more time and energy on diabetes management.

    Trying to make positive changes in your diabetes management now is even more important in the context of this pandemic.

    Find fitness activities you can do from the comfort of your home here.

    Any final tips on how to stay motivated?

    Remind yourself that this pandemic will eventually end and it’s about figuring out how you’re going to rise above this in the meantime. Remember the three Cs: Connection, Contribution and Creativity. Even with physical distancing and other restrictions, here’s a chance to reconnect with old friends, spend quality time with a pet, or get back to an activity you enjoyed in the past.

    Here are some online entertainment and social activities to consider as you’re socially distancing

    [/vc_column_text][read-also-article article-slug=”covid-19-support-services/”][/vc_column][/vc_row]