A new US study explores how diabetes distress and mental health problems can affect each other
Living with type 1 diabetes is about more than managing glucose levels and taking insulin. It takes a toll on emotional wellbeing.
A recent study in Diabetic Medicine looked at experiences of people living with both type 1 diabetes and mental health problems. The research team wanted to know how diabetes and mental health problems can affect each other.
The research team ran five online group discussions. Twenty-one adults with type 1 diabetes living in the United States took part. All had received mental health care, and most had been diagnosed with a mental health condition.
When diabetes distress and mental health problems overlap
The research team identified two main themes from discussions.
- The weight of unseen struggles
People spoke about the constant effort of managing type 1 diabetes. They have to make many decisions each day, with no real break from diabetes.
Participants described:
-
- feeling exhausted or burnt out
-
- always having to watch their glucose levels
-
- worrying about low glucose (also called hypoglycaemia or hypos)
The study also showed how diabetes distress and mental health problems can affect each other.
Diabetes distress is the emotional burden of living with and managing diabetes. It is not a mental health condition, but a person can experience both. For some participants, diabetes distress could make anxiety or depression worse. One example was the worry caused by hypos. Some signs of a hypo, such as sweating or a racing heart, can also feel like anxiety or panic.
- The burden of being ‘Othered’
Adults reported feeling judged, left out or misunderstood because of their diabetes. Diabetes stigma affects how people view themselves, their relationships with others and how they are treated at work, in public places and when using services.
Fear of negative reactions from others led some people to hide their diabetes or avoid managing it in public. Participants also described feeling like they did not “fit in” with others. Experiences of stigma and exclusion contributed to feelings of isolation, self-consciousness and distress, highlighting how diabetes stigma can worsen mental health challenges.
What does this mean for diabetes care?
The findings show that type 1 diabetes can affect both physical and mental health. People may face diabetes distress, mental health problems, stigma and isolation alongside the daily demands of diabetes.
The study also highlights the need for mental health services that understand diabetes. People in this study described times when mental health services did not understand type 1 diabetes or their diabetes care needs.
The researchers call for mental health support that understands both mental health and life with type 1 diabetes. They also suggest making mental health support a key part of diabetes care.
Reference:
Cooper ZW, Davis GM, Pasquel FJ, Johnson LCM. Navigating the dual burden of type 1 diabetes and mental illness: A phenomenological study. Diabet Med. 2026 Apr;43(4):e70200. doi: 10.1111/dme.70200. Epub 2026 Feb 5. PMID: 41641584; PMCID: PMC12982632.
