The psychological impact of type 1 diabetes (T1D) is increasingly more recognized. Unarguably, managing a chronic illness can affect one’s mental health, and conversely, maintaining good psychological health can help in the daily management of T1D. This illness affects all spheres of life and can also affect mood and self-esteem. People with T1D should discuss the mental health challenges they face with their healthcare team and loved ones, including diabetes burnout.
Psychological flexibility and HbA1c
Psychological flexibility allows an individual to respond appropriately to change and the unexpected, to tolerate discomfort and a temporary loss of control without experiencing emotional distress, and to keep going despite these obstacles. It is intricately linked to resilience.
Researchers have assessed the psychological flexibility of participants with T1D and its impact on their HbA1c, which is a major indicator of blood sugar management. They observed that good psychological flexibility scores were generally associated with an HbA1c level that is closer to the recommended targets.
This study could challenge the prevalent notion that in order to manage diabetes, one needs to control it. The results suggest that a very rigid, strict approach may actually undermine the ability to achieve target blood sugar levels. The researchers also found that participants who had the most confidence in their ability to manage their T1D reported feeling less distressed about their illness.
Well-being and time spent in range
A second recent study provided more insight into the issues that were examined in the first study. The researchers observed that participants with T1D who spent more time in range reported a better overall mood.
This could be due to various reasons. It is entirely possible that blood sugar levels have an impact on mood and vice versa. Or a person with T1D could be in a better mood when their blood sugar levels are in range for a whole day. Or they could feel better if they didn’t have to deal with the physical side effects of hypoglycemia and hyperglycemia.
It is safe to say that mental health and T1D management influence one another.
The BETTER registry questionnaires assess certain aspects of psychological health such as diabetes-related distress and well-being.
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- Polonsky, W., Fortmann, A. L. (2020). The influence of time in range on daily mood in adults with type 1 diabetes. Journal of Diabetes and Its Complications, 34(12). doi:10.1016/j.jdiacomp.
- Nicholas, J. A., Yeap, B. B., Cross, D., Burkhardt, M. S. (2021). Psychological flexibility is associated with less DIABETES distress and lower glycated haemoglobin in adults with type 1 diabetes. Internal Medicine Journal. doi:10.1111/imj.15250