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April 30, 2003

Behavior, Daily Care

Question from London, England:

I have clinical depression and am taking medication, but since having depression I have not had stable blood sugars, and my average was 9 mmol/L [162 mg/dl] at my last doctor's visit. Part of my depression was caused by diabetes, and sometimes I don't take my injections in protest. However, at other times i take them all (like I am meant to), and still my sugars is too high one minute, the next minute I'm eating loads of chocolate because I am hypo, and then it goes high again. I can't win. I was in hospital with DKA [diabetic ketoacidosis] a few months ago, and I just can't cope. How can I not be stressed? Are my blood sugars all over the place because of stress? Can my sugars ever go back to normal? I'm scared I'll get really fat and get loads of complications.

Answer:

Believe me, I understand your issues with depression. It is difficult to brush your teeth, much less manage diabetes when you are in a clinical depression. I hope the medication has helped with your depressive feelings. However, there are a host of anti-depressants, and perhaps you could have your medication rechecked for its efficacy.

Having said that, I am glad you know that not taking your insulin is an act of rebellion and does not serve you well. Blood sugars can be influenced by stress and anxiety. Have you considered means by which you can take control of your moods? For instance, have you looked into classes on stress management, support groups, yoga, or any other activities that would lessen your feelings of isolation and add to your feelings of empowerment? Have you knowledge of any such classes or groups locally that can help you take charge and not feel like a victim of your diabetes? I think it is worth investigating.

Yes, you can turn this into a more manageable condition, but you must first decide to take a step in your own direction.

CMB