When you live with type 1 diabetes, your everyday normal activities both affect your blood glucose levels and are affected by your blood glucose levels. Every time that you want to eat, exercise, drive, go for a walk around your neighborhood, go out for a drink with friends, there are extra considerations that you have to take because of diabetes. This added stress can take a toll on people with diabetes and their loved ones, adding to increased risks for mental health challenges.
Recently, researchers in Slovenia published a literature review about psychosocial factors that affect the onset and management of type 1 diabetes.1 They suggest that although it’s important to recognize the effects diabetes have on a person’s psychosocial well-being, it’s also important to evaluate the effects that psychosocial factors have on diabetes itself as well. They suggest looking at the psychosocial factors at both angles and how they are related as opposed to taking a single-sided view.
The researchers found data from Sweden and Denmark that suggest people who develop type 1 diabetes experienced psychological stress in early childhood.1 One of the studies in Sweden showed that when children less than two years of age experienced a significant life event such as death of a close family member, severe disease in the family, a serious accident, violence, etc. significantly increased the risk of the population of 3,784 parents they interviewed. This correlates with the growing body of evidence about adverse childhood experiences that increase risks for people throughout their lifetime.
They also reviewed data from various studies about stress regulation and the role of attachment, which has been studied by psychologists for some time and more recently being reviewed in relation to type 1 diabetes. A study of 77 mother-child pairs showed that a more secure attachment correlated with a lower HbA1c, but only in male children. Another study on 31 families with adolescents showed that if the mothers perceived a strong attachment, it was more likely the adolescents would have a lower HbA1c.
Some of the other factors that have been shown to have a positive effect on HbA1c in children are:
- Family communication
- Parental guidance with diabetes-related care especially continuing into adolescence and young adulthood
- Positive parental emotional support
With respect to diabetes’ effects in the psychosocial realm, key findings were an increased risk for depression, anxiety and eating disorders in children and adolescents. These mental health challenges are correlated with worse glycemic control and can be cyclical in that the worse the glycemic control, the worse the person feels, and so on. There is also an increased risk for suicide attempt, and there is a group of researchers working on reducing suicide rates for people with diabetes.
The big takeaways from this literature review are that stress affects everything, and everything affects stress. There will always be stressors in our lives, whether or not we have diabetes, and whether we like it or not! The key is navigating the stress management in your life with your family, getting evaluated for diagnostic psychological conditions, and communicating with your family member who has diabetes.
And there is NO SHAME in getting the help you or your family needs, after all, as the saying goes, it takes a village. Sometimes that village involves anti-depressants, good friends who understand what you’re going through, a good counselor, your family, and whatever else helps you make it through your current challenges.
- Psychosocial factors affecting the etiology and management of type 1 diabetes mellitus: A narrative review
Written and clinically reviewed by Marissa Town, RN, BSN, CDCES