Beyond Blood Sugar: The Impacts of Diabetes on Mental Health

People often discuss and bring awareness of the physical impacts of diabetes such hypoglycemia, hyperglycemia, loss of vision, or limb amputations.  While the physical impacts of diabetes are serious, diabetes also has a serious impact on an individual’s mental health. As part of National Minority Mental Health Awareness Month, this blog will explore the relationship between mental health and diabetes, and how BIPOC (Black, Indigenous, and People of Color) communities are impacted by diabetes and mental health. 

The relationship between mental health and diabetes can have serious consequences for those living with and managing their diabetes.  Individuals with type 1 or type 2 diabetes are at an increased risk for depression, anxiety, and eating disorder symptoms and diagnoses¹. An initial diabetes diagnosis can increase the risk for depressive or anxiety-related symptoms. Conversely, an individual with depression may have a higher risk for developing diabetes, and an initial diabetes-related complication can increase the risk for developing anxiety-related symptoms¹.  In the case of eating disorders and disordered eating, women with type 1 diabetes are twice as likely to be diagnosed with an eating disorder while African American women with type 2 diabetes are more likely to engage in disordered eating such as binge eating¹. A diabetes diagnosis and the burden of maintaining one’s diabetes self-care can also lead to diabetes distress in which an individual may experience negative emotions and daily fatigue from trying to manage their diabetes². All these mental health concerns are associated with poorer diabetes self-management, worse health outcomes, and higher mortality rates^1,2. 

In addition to the general impacts of diabetes on an individual’s mental health, BIPOC communities face unique experiences and challenges when it comes to managing their mental health and diabetes. Health and social disparities in diabetes health and mental health negatively affect BIPOC communities³. Among Latinos and African Americans with diabetes, higher levels of experienced discrimination and psychological stress was associated with higher diabetes distress³ and lower diabetes self-care and efficacy^4. Higher experiences of diabetes distress among BIPOC individuals with diabetes were found to have worse health outcomes such as higher HbA1c levels^3,5. Additionally, cultural stigmas around accessing mental health care can prevent an individual with diabetes from receiving the care they need for their mental health which can affect their ability to manage their diabetes³. Overall, BIPOC populations are more likely to experience the burden of diabetes-related complications and are less likely to receive the recommended diabetes preventative care⁶. With the established relationship between diabetes health and mental health, barriers to mental health treatment and resources would continue to make diabetes management and prevention difficult for BIPOC communities.  

Finding and accessing diabetes and mental health resources does not have to be difficult for BIPOC communities. A first step in a mental health wellness journey and diabetes self-management care can go a long way. Here are some resources to get someone started on their wellness journey. 

Mental Health America (MHA) 

• Find BIPOC Mental Health resources at https://mhanational.org/bipoc-mental-health/  

African American Diabetes Association  

• Find BIPOC and underserved diabetes resources at https://www.africanamericandiabetes.org/resources  

National Alliance on Mental Health Illness (NAMI) Support Line 

• Call 1-800-950-6264 

• Text “NAMI” to 62640 

Experiencing a crisis? 

• Call or text 988 

References 

1. Ducat, L., Philipson, L. H., & Anderson, B. J. (2014). The mental health comorbidities of diabetes. JAMA, 312(7). https://doi.org/10.1001/jama.2014.8040 

2. Skinner, T. C., Joensen, L., & Parkin, T. (2019). Twenty‐five years of Diabetes Distress Research. Diabetic Medicine, 37(3), 393–400. https://doi.org/10.1111/dme.14157  

3. Butler, A. M., Brown, S. D., Carreon, S. A., Smalls, B. L., & Terry, A. (2022). Equity in psychosocial outcomes and care for racial and ethnic minorities and socioeconomically disadvantaged people with diabetes. Diabetes Spectrum, 35(3), 276–283. https://doi.org/10.2337/dsi22-0006  

4. Peña-Purcell, N., Han, G., Lee Smith, M., Peterson, R., & Ory, M. G. (2019). Impact of diabetes self-management education on psychological distress and health outcomes among African Americans and Hispanics/Latinos with diabetes. Diabetes Spectrum, 32(4), 368–377. https://doi.org/10.2337/ds18-0081  

5. Özcan, B., Rutters, F., Snoek, F. J., Roosendaal, M., Sijbrands, E. J., Elders, P. J. M., Holleman, F., Pijl, H., Tack, C. J., Abbink, E. J., de Valk, H. W., Wolffenbuttel, B. H. R., Stehouwer, C. D. A., Schaper, N. C., Dekker, J. M., & Schram, M. T. (2018). High diabetes distress among ethnic minorities is not explained by metabolic, cardiovascular, or lifestyle factors: Findings from the Dutch diabetes pearl cohort. Diabetes Care, 41(9), 1854–1861. https://doi.org/10.2337/dc17-2181  

6. Haw, J. S., Shah, M., Turbow, S., Egeolu, M., & Umpierrez, G. (2021). Diabetes complications in racial and ethnic minority populations in the USA. Current Diabetes Reports, 21(1). https://doi.org/10.1007/s11892-020-01369-x  

By Julian Robles

Julian Robles is a research assistant in the Living F.R.E.E. Lab.