Examining the Relationship Between Diabetes and Mental Health

Stefan Hartmann

2021 Dec 13

10 min read

The relationship between diabetes and mental health is a common focus of studies in recent times. Many studies suggest that people who have diabetes may also be susceptible to several psychological and mental health conditions, and vice versa.

However, the link between the two is generally psychological, as people managing diabetes and high blood glucose tend to become less aware of their environment and slowly become distressed. Mental health professionals confirm that most diabetics, despite not being diagnosed, suffer from several underlying mental health conditions.

This detailed guide thoroughly examines the relationship between diabetes and mental illness. Namely, it clarifies whether the duo is a cause for concern and examines the different types of diabetes-associated mental disorders alongside their therapy.

The Connection Between Diabetes and Mental Health

Diabetes can cause severe changes to your lifestyle. This can be pretty challenging as you would need to adapt to new ways of doing things and become more conscious of the kind of food you eat.

Generally, people with diabetes risk being mentally affected at the early stage of their diagnosis. Some get past it and synchronize their minds to the new challenges, while others get stuck. Over time, the latter group may exhibit mild to severe mental conditions, including disassociation from family and environment.

Safe to say, having a mental health crisis or any kind of mental illness can make it challenging to keep up with your diabetic routine. Studies suggest a bidirectional relationship between diabetes and mental health. A person with diabetes can suffer from several psychological conditions over time and be exposed to the same risks as people with only mental disorders.

The American Diabetes Association established an unclear link between mental health and diabetes following results from the German National Health Interview and Examination Survey. The study “On the Association Between Diabetes and Mental Disorders in a Community Sample established that people with diabetes aren’t significantly likelier to meet the minimum of one mental disorder criteria of the 4th edition of the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV) than those without diabetes.

It also confirms that people with diabetes having anxiety or affective disorders had optimal glycemic control more often than not. Additionally, it reveals that while people with diabetes were more at risk of having affective disorders, the results had little statistical significance after considering variables like age, socioeconomic status, marital status, and sex.

Conversely, the same study indicates that the link between anxiety disorders and diabetes remained significant after considering these variables. Furthermore, the study suggested that diabetes may not cause a mental disorder. However, there’s a likelihood that diabetics could end up with several mental conditions that are purely born from their state of mind.

With many revelations coming from the Center for Disease Control (CDC) and the American Diabetes Association (ADA), mental health professionals have sought to offer patients a better treatment plan in tackling mental issues. Treatment has focused on reducing the psychological effects of diabetes of the type 2 form as it’s the more prevalent type of diabetes.While the link between diabetes and mental illness is strong and quite disturbing, the good news is that an improvement in the management of diabetes will also trigger an improvement in mental health and vice versa.

Identifying Mental Health Issues as a Diabetic

While most people with diabetes complications may also suffer from mental disorders, only very few actually know that they’re going through such. For most people, the psychological effects of diabetes aren’t really a thing, and that’s where they get it wrong. Many anxiety disorders can be related to diabetes, and diabetics must know that they may be susceptible to any of them if they hope to manage their condition better.

The biggest challenge with identifying diabetes-associated mental health disorders is the common denial and reluctance of diabetics to seek the assistance of mental health professionals. An estimated 45% of mental distress in diabetes is generally left undetected, with most of them not knowing that they suffer from some medical condition.

On top of that, other research suggests that only one-third of diabetics with mental health conditions get proper diagnoses and related treatment. Most generally associate the symptoms with everyday stress or diabetic symptoms.

To identify your mental health condition as a diabetic, you’d need to get a proper diagnosis from a doctor, as that’s the only way to be sure. A mental health screening remains the best option to identify if you’re going through any mental condition.

Apart from a diagnosis, though, there are often noticeable signs that could point to you having a mental health condition. Subsequent sections help you understand if your diabetic condition could be causing you psychological distress and touch on how to manage them.

Types of Mental Health Issues Associated With Diabetes

Still not sure of the mental illnesses linked with high blood sugar levels? The following sections illuminate this topic.

Eating Disorder

There are two major eating disorders connected with diabetes — binge eating and bulimia.

For people suffering from the psychological effects of diabetes of the type 2 form, binge eating is the more common variant. Binge eating is generally considered as excessive compulsive eating without control. The person only gets to stop when their body can no longer take more.

For people with type 1 diabetes, bulimia is the more common eating disorder, and it’s simply a combination of binge eating and purging (vomiting). The subsequent purging is a deliberate act carried out by the person to get rid of the food already consumed to avoid weight gain. Other unhealthy means of preventing this weight gain include excessive exercise and fasting.

Both eating disorders are serious mental health problems, with bulimia considered a life-threatening condition.

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Anxiety and Stress

Anxiety and stress are more common mental health conditions attributed to diabetes. The most popular condition is generalized anxiety disorder (GAD) and is experienced mainly by diabetics at the beginning stage of their condition after diagnosis.

This mental disorder may go away after a while or could linger on. It’s a risk as it affects a person’s daily life. If not quickly diagnosed, it could become worse and lead to distress.

Psychological Distress  

People with diabetes can sometimes feel frustrated, worried, tired, or discovered as they have to follow a diabetes care plan every day. Some may think that the disease controls them. Others may develop the condition slowly when they believe that their diabetic care fails, or they develop a different ailment or have sick days.

A significant symptom of distress is the sudden feeling of being overwhelmed with everything surrounding your condition. You could start skipping appointments with your doctor or default checking your blood sugar. This generally happens when you start thinking of how long you have had to follow a routine and how limiting it can be.

However, it’s important to note that distress and depression are quite different. While diabetes can trigger both, distress is a medical condition ranging from mild to severe. Moreover, severe psychological distress could generally lead to depression.


Depression is a later-stage mental health condition associated with diabetes. Most diabetics won’t get to this point, but urgent medical attention is generally needed when they do. There are different stages of depression, with comorbid depression being among the latter.

Comorbid depression, also known as a comorbid psychiatric disorder, combines a series of conditions, including affective disorders, anxiety disorders, somatoform disorders, and abuse/dependence disorders. It’s a major depressive disorder, and anyone experiencing it may not see a purpose to their existence.

Treatment and Therapy​​

Although diabetes may not have a definite treatment period, you can adequately manage the associated mental health disorders. All mental health conditions, including comorbid mental disorders, can be successfully treated with the right therapy and medication.

There are more than a few diabetes clinics dedicated to mental health screening, and they generally handle the management of diabetes and mental health in three stages.

Stress Management

A health care team or clinic will generally suggest a therapeutic stress management routine to handle your condition if it’s at the beginning stages. Treatment at this stage doesn’t involve any medication and is generally focused on acknowledging self-value.

While there’s no one-way-fits-all method to carry out stress management therapy, here’s an outline of the general tips offered by most doctors and clinics:

  • Maintain a high level of self-worth
  • Have a positive attitude
  • Talk to a loved one
  • Exercise and eat right
  • Practice relaxation skills such as visualization, deep breathing, or meditation
  • Book an appointment with a diabetic educator
  • Visit a mental health professional who has experience dealing with diabetic patients
  • Visit an endocrinologist — a special doctor that understands better the challenges of diabetes more than a typical doctor


Suppose stress management doesn’t help your condition as much as you want. In that case, you may consider registering with a professional to help you walk and work through your distress or issues. At this stage, there are three different types of therapy available.

Cognitive-behavioral Therapy (CBT)

Cognitive-behavioral therapy is generally focused on two areas — cognitive and behavioral.

Cognitive therapy is designed to help you develop a positive belief about yourself and life, while behavioral side therapy encourages you to take healthier actions. This type of therapy works well for depression and distress.

Family Therapy

Family therapy generally involves a family, including the diabetic. The family is enlightened on ways to help the diabetic live better and avoid irregular eating habits. It’s also designed to treat conditions such as bipolar disorder.

Dialectical-Behavioral Therapy

This therapy focuses on the diabetics learning essential control skills with the guidance of a professional. The focus skills to be learned include:

  • Mindfulness
  • Emotion regulation
  • Distress tolerance
  • Interpersonal effectiveness


Medication is generally the last option and must be strictly administered by a mental health professional. They may prescribe antidepressants such as SSRIs (selective serotonin reuptake inhibitors, e.g., fluoxetine) and TCAs (tricyclic antidepressants, e.g., amitriptyline) to control blood sugar levels for people with diabetes 2.

Research suggests that using these antidepressant medications in depressed patients may increase the chances of optimal glycemic control by 200% compared to depressed patients who don’t use these medications. However, there are claims that TCAs and SSRIs may induce weight gain, boosting the chances of having diabetes. Hence, you should consult a medical professional for advice before commencing these medications.


It’s clear that there’s a link between diabetes and mental health. As a person with diabetes, you must recognize that psychological awareness and responsibility are just as important as major treatments. Abandoning or paying less attention to your mental health could lead to several conditions that degrade your health and underlying condition.

This article outlines the different mental conditions that could result from being a diabetic and how you can properly manage them and enjoy your daily life. Our revolutionary app, Klinio, is an excellent guide that helps plan your meals, reducing your risk of slipping into binge-eating and bulimia. Klinio also doubles as a virtual caregiver, offering continual guidance tailored for each individual that carves out your path towards improved health.

Written by

Stefan Hartmann

Stefan Hartmann attended the University of Central Florida while working as an Emergency Department Scribe with the goal of practicing medicine one day. He graduated Magna Cum Laude with a Bachelors's in Sports & Exercise Science in 2015. He continued working full time and immediately began work as a Master Trainer at LA Fitness. There he helped clients of all ages and abilities achieve their fitness goals through one-on-one personal training. He then moved to Massachusetts and completed the Physician Assistant Program at Bay Path University from 2016-2018. He has been working as a PA in Urgent Care and Primary Care. Stefan is a firm believer that chronic disease is 100% reversible through Nutrition, Exercise, and the right supplements and alternative modalities.

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