Recognizing the Signs of Diabetes: Physical and Emotional Symptoms
Posted by Improving Lives Counseling Services, Inc. | Mental Health
“Approximately 38.4 million Americans, or 12% of the population, have diabetes. The majority of these cases are linked to obesity, poor diet, and a sedentary lifestyle. Recent statistics estimate that 96 million adults have prediabetes and an increasing number of children are being diagnosed each day. It is believed that about 8.7 million Americans remain undiagnosed. In support of both the diagnosed and undiagnosed, November is recognized as American Diabetes Month, with November 14, 2024, designated as World Diabetes Day. People with diabetes are 2 to 3 times more likely to have depression than people without diabetes – yet only 25% to 50% get diagnosed and treated.
Improving Lives Counseling Services’ diverse team of counselors, therapists, and clinicians use a variety of behavioral and psychosocial interventions in treating the operant behaviors (deficits / excesses) associated with a medical diagnosis of diabetes.
TYPES OF DIABETES
Children as young as 4 and seniors as old as 90 can be diagnosed with diabetes. Causes, symptoms, physical, and psychological effects and treatment can vary with each type. Diabetes is a condition that happens when blood sugar is too high. “Most forms of diabetes are chronic (lifelong) and all forms are manageable with medications and/or lifestyle changes.”
Prediabetes
Prediabetes is the stage before a diagnosis of type 2 diabetes where blood glucose levels are elevated but not high enough for an official diagnosis. It indicates an increased risk of developing diabetes and can occur without noticeable symptoms. Regular screening is important for children whose mother, father, or sibling has been diagnosed with diabetes. Prediabetes also increases the risk of heart disease and stroke. Knowing there is a risk of diabetes from a young age can impact mental health and well-being.
Type 1 Diabetes
Type 1 diabetes is an autoimmune disorder. The body’s immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. Up to 10% of people who have diabetes have Type 1. It’s usually diagnosed in children and young adults. Symptoms may include increased thirst, frequent urination, extreme fatigue, blurred vision, and unexplained weight loss. In adults, Type 1 diabetes affects home life, work life, parenting and caregiving, intimacy, and relationships. Type 1 diabetes can lead to heart disease, kidney damage, nerve damage, and eye problems. “Patients experience mild cognitive decrements as well as affective, behavioral, and intellectual disorders”.
Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes. It primarily affects older teens and adults, but due to increasing rates of obesity in children, it is becoming more commonly diagnosed in younger populations. In type 2 diabetes, the body becomes resistant to insulin, the hormone that regulates blood sugar levels, or the pancreas fails to produce enough insulin. Risk factors include obesity, high blood pressure, and abnormal cholesterol levels. Symptoms may include frequent urination, fatigue, blurred vision, and increased thirst. Type 2 diabetes is often undiagnosed because symptoms can be subtle or unnoticeable and factors like lack of health insurance and stigma may contribute to underdiagnoses.
Many adults with type 2 diabetes experience psychosocial burden and diabetes-related distress, which can negatively impact self-care behaviors and disease management. When blood sugar levels are too high or too low, patients may experience stress, depression, anxiety, and mood swings. Mental health and well-being play a significant role in the control and management of diabetes. Type 2 diabetes is also linked to two conditions that increase the risk of foot amputation: peripheral artery disease, which narrows the arteries that supply blood to the legs and feet, and diabetic neuropathy, which causes nerve damage.
Type 2 diabetes disrupts daily life and can affect mental health and well-being. Blood glucose levels must be regularly checked, food choices need to be planned and carefully selected, and finger pricking can be inconvenient and uncomfortable. Wearing a continuous glucose monitor (CGM) can also be challenging, as it may alert in public or be noticed by family and co-workers. Additionally, individuals must find time to exercise, manage cholesterol and blood pressure, and schedule regular doctor visits. Patients may worry about physical side effects, maintaining health insurance, and the cost of medications.
Other Types of Diabetes
Type 3c diabetes occurs when the pancreas is damaged, affecting its ability to produce insulin. Latent autoimmune diabetes in adults (LADA) results from an autoimmune reaction. Maturity-onset diabetes of the young (MODY), also known as monogenic diabetes, is caused by an inherited genetic mutation. Neonatal diabetes develops within the first six months of life. Brittle diabetes is a form of type 1 diabetes characterized by severe episodes of high and low blood sugar, often requiring hospitalization. Conditions like pancreatitis, cystic fibrosis, pancreatic cancer, and the removal of the pancreas can all lead to diabetes.
PHYSICAL EFFECTS – SYMPTOMS
Beyond the health-related issues outlined above, diabetes can damage the blood vessels of the heart, brain, and legs. Increased urination, low energy, weight gain or loss, swelling in the lenses of the eyes, slow healing of cuts and wounds, gum disease, heart disease, kidney disease, high blood pressure, and the risk of stroke are physiological effects of diabetes.
Often, there are no noticeable symptoms of diabetes. A person’s A1C level might be considered if there is a family history of diabetes or if someone reports extreme fatigue, frequent urination that disturbs sleep, numbness or tingling in the hands and/or feet, unexplained weight loss, slow-healing sores, or unexplained dark patches on the neck or in the armpits. Symptoms of diabetic polyradiculopathy typically affect one side of the body; a person may find they cannot look to the left or right. Proximal neuropathy may include weakness or muscle atrophy, as well as severe pain in the buttocks, hips, or thighs.
MENTAL HEALTH EFFECTS
Diabetes of any type can lead to a loss of interest in school, work, extracurricular activities, and social engagements. Low self-esteem and a negative self-image can contribute to feelings of failure. Relying on medication and the need for constant monitoring can foster a sense of helplessness and frustration. Many individuals find taking pills and administering injections to be burdensome, and they may feel self-conscious if someone opens their refrigerator and asks, “What’s this?” Additionally, the knowledge that failing to manage diabetes can result in serious health complications such as limb loss, vision impairment, kidney damage, hospitalization, or even death can heighten feelings of defenselessness and vulnerability.
“Mental disorders in diabetics are more prevalent than in the general population. An increased prevalence of depression and suicide is high among diabetic individuals. Risk factors including history of depression, presence of comorbidity, younger age, lower education, low social support, presence of diabetic complications, poor glycemic control and physical impairment, all increase the risk of suicidality.”
EFFECTS ON THE BRAIN
Research suggests that diabetes can lead to changes in brain structure, as prolonged high blood sugar levels can damage the blood vessels that carry oxygen-rich blood. Insulin resistance, common in type 2 diabetes, can alter brain metabolism and reduce glucose utilization, impacting thinking, memory, and decision-making. Untreated diabetes can affect mood, learning abilities, verbal memory, and the ability to perform daily tasks. Additionally, diabetic neuropathy can affect nerve pathways, potentially leading to sensory issues and altered perceptions, and may increase the risk of vascular dementia.
SUMMARY
Diabetes is a serious illness that affects both physical health and mental well-being. The stress of managing the disease and its physical effects can lead to chronic stress, anxiety, and depression. An increased prevalence of depression has been reported in individuals with diabetes mellitus, often leading to panic disorder, personality disorders, irritability, alcoholism, substance abuse, criminal behavior, and suicidal thoughts. For emotional well-being, controlling diabetes-related distress, coping with the illness, managing diabetes, addressing co-occurring conditions, and preventing cognitive decline, anyone displaying symptoms or diagnosed with diabetes of any type should make therapy a part of their healthcare program.
Improved Lives Counseling Services’ diverse team of licensed, professionally trained counselors, therapists, and clinicians plays a crucial role in providing valuable psychological and psychosocial support, as well as holistic care, in the diagnosis, treatment, and management of diabetic patients. Diabetes is a manageable disease, and with proper physical and mental health care, diabetic patients can live the lives they were meant to lead. Call us to learn more.
