Psychology – stress – depression in diabetic patients

Nguyen Hoang Vu, MD, MSc

Diabetes mellitus (DM) not only affects physical health but also profoundly impacts the behavior, psychology, and emotions of patients. The daily requirement to monitor blood glucose, follow a strict diet, exercise regularly, and take lifelong medication causes many people to feel pressured, anxious, and even depressed and stressed. This is a very common condition. However, many people still do not pay attention to mental health, leading to poorer blood glucose control and a decreased quality of life.

1. Definitions

Stress (diabetes distress) is an emotional response to living with the disease, the burden of daily self-management, and worrying about long-term complications. It can also arise from social impacts (e.g., stigma, discrimination). If not addressed promptly, mild stress can become severe and even lead to depression.

Depression is a more serious medical condition, characterized by prolonged feelings of sadness, despondency, and a loss of joy and interest in life. Depression affects thoughts, physical feelings, and behaviors.

Easy ways to recognize:

Stress:

– Frequent worry about blood glucose and complications

– Irritability, annoyance towards loved ones

– Mental fatigue, forgetting to take medication or check blood glucose

– Difficulty sleeping or sleeping a lot but not feeling rested

Depression (needs attention if lasting ≥ 2 weeks):

– Feeling sad almost all day, for no apparent reason

– Loss of interest in everything (enjoying food, watching movies, meeting family/grandchildren…)

– Feelings of worthlessness, guilt, or that “life is meaningless”

– Poor appetite or overeating, unexplained fatigue

– Thinking that things would be better if you were dead or having suicidal thoughts.

2. Risks

– People with diabetes have a high risk of stress and are 2-3 times more likely to experience depression compared to the general population. Prolonged high blood glucose affects the brain, impacting your mental well-being. In addition, due to financial pressure, fear of complications (heart, eyes, kidneys, feet), and lifestyle changes.

– If left unmanaged, stress and depression make it harder to control blood glucose, increase complications, and reduce the quality of life.

3. Management

3.1. Daily mental health care:

– Talk with friends, family, or colleagues: helps you relieve stress.

– Move more: When you exercise, your body releases endorphins, chemicals that help you feel good. Exercising to improve your mood can really help you feel better, and can also help you manage diabetes.

– Connect: Join a Diabetes Patient Club to share experiences.

3.2. In cases of severe stress or depression:

– If you experience any depressive symptoms lasting more than two weeks, it is important to see an endocrinologist and a mental health professional for advice and treatment.

Conclusion: Poor mental health is a very common condition in people with diabetes. Early detection and proper management will help you live a healthy, joyful life and significantly reduce complications.

References:

1. American Diabetes Association Professional Practice Committee. Standards of Care in Diabetes 2025 – Mental Health. Diabetes Care. 2025;48(Suppl 1):S50-S72.
2. Diabetes UK. Emotional health for professionals guide. Chapter 3: Diabetes distress [Internet]. London: Diabetes UK; 2023 [cited 2026 Apr 30].
3. Diabetes UK. Emotional health for professionals guide. Chapter 6: Depression [Internet]. London: Diabetes UK; 2023 [cited 2026 Apr 30].