Living with Diabetes
Diabetes brings many challenges. If you or a
family member have been diagnosed with diabetes, it will strongly affect your
life. This page describes diabetes types 1 and 2; common emotional
complications and possible treatments.
- Diabetes Mellitus
- Type 1 Diabetes
- Type 2 Diabetes
- Complications of Diabetes
- Psychological Complications of Diabetes
- Relationship Coaching
1. What is Diabetes?
If your body produces little or no insulin (insulin
helps cells absorb sugar for energy), sugar builds up in your blood and urine, causing
excessive urination, thirst, hunger, and digestion problems,
which interferes with cellular function. These symptoms are called diabetes.
Diabetes is most
common if you are over 45 years old; if you
are overweight and/or physically inactive; if you have family members with diabetes; and if you are of African, Hispanic
or Native
American descent. Diabetes cases are classified as Type 1 and Type 2.
2. Type 1 Diabetes
Type 1 diabetes is an
autoimmune disease - the body's immune system attacks and destroys cells that
produce insulin. Symptoms of Type 1 diabetes usually appear suddenly in
people under 20 years old. Type 1 diabetes is called juvenile-onset diabetes.
3. Type 2 Diabetes
In Type 2 diabetes your body does not
balance insulin production and your body cells cannot use insulin efficiently.
Symptoms of Type 2 diabetes include those found in Type 1 , as
well as repeated infections or skin sores, generalized tiredness and
numbness in the hands or feet.
About 9 out of 10 diabetics have Type 2 diabetes. This usually
starts after the age of 45, although the incidence of the disease in younger
people is growing. The symptoms develop slowly, and may not be recognized. Type 2 diabetes is called adult-onset
diabetes.
4. Complications of Diabetes
UIgnored diabetes may cause life-threatening
complications, including coma or death. Other
complications include blindness, kidney failure, high
blood pressure, heart attack, and stroke.
Diabetes may also cause loss of feeling,
particularly in the lower legs, which may prevent a person from feeling skin
damage or infection until complications develop, possibly necessitating
amputation. Burning, sensitivity and coldness of the
foot can also occur. Other complications include higher-risk pregnancies
in diabetic women.
There is a strong relationship between Type 2 diabetes and obesity. About
80 percent of people with Type 2 diabetes are significantly overweight.
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5. Psychological Complications of Diabetes
The successful treatment of
diabetes resolves psychological difficulties as well as poor sugar control - which can cause further psychological problems. Common
psychological factors are:
5a. Following the treatment
- Diet and exercise
- Insulin management
- Injections
- Insulin shock
5b. Relationships with families, friends and professionals
People with diabetes may respond emotionally to their
hormone levels, and sometimes experience mood swings. A person with diabetes
may express long-withheld emotions - sometimes chaotically. A diabetic patient may be
unaware of even severe mood swings; and act as if a current emotion is
a valid basis for long-term decisions. Emotional outbursts may follow minor
events.
For example, a person with diabetes may angrily criticize other family
members, or suddenly announce a major decision to business
associates. Yet a diabetic may quickly forget the conversation. Criticized family members, and
business associates affected by these decisions may respond with their own
emotions and lower
their trust of the diabetic person. Emotional conflicts can spiral to create
chaos.
5c. Managing Emotions, Beliefs and Stress
- Guilt, anger, fear and sadness
- Beliefs about cause, seriousness, treatment effectiveness
- Depression
- Stress and trauma
Guilt, anger, fear and sadness
Strong unpleasant emotions affect both mental stability
and hormone levels. Conversely, hormonal therapy can precipitate displays of withheld emotions. The primary emotions are usually
guilt anger, fear and sadness; which may support many secondary emotions.
- Guilt is usually a conflict about having
hurt other people
- Anger is usually related to violated values
- Fear is usually a reaction to possible
future events
- Sadness is usually regret about lost
possibilities for happiness
If the whole family knows that diabetics may express wild emotions at unpredictable times - diabetics,
their families and
friends can better cope with emotional outbursts.
Beliefs about cause, seriousness and treatment
effectiveness
People who blame themselves for their diabetic condition
are often accurate, as type 2 diabetes is strongly related to lifestyle and
obesity.
However, some people diagnosed with diabetes may try to blame others, often
family members, for "making them" live an unhealthy lifestyle.
Although diabetes has potential unpleasant complications,
most diabetic symptoms can be successfully controlled by diet, exercise,
sugar control and medication.
The effectiveness of treatment
is primarily the responsibility of the patient. A person with diabetes can
become knowledgeable about the disease. A boost to health is to join or
start a support-group, to help other people learn about the
disease, its treatment and its consequences.
Depression
Depression with obesity predict adult-onset
diabetes. Depression may also increase insulin production. People with
diabetes are more likely to suffer from depression than normal. Depression may
reduce the desire to take medications and/or to follow the prescribed
treatment for diabetes.
Depression is often a
healthy response to an unhealthy environment or chaotic relationships. Often,
the underlying issue is guilt. If a person feels guilty, life may not make
sense, which leads to depression. Most depressive guilt results from:
-
Abuse, betrayal or abandonment
(violating trust; for example - abandoning a child)
-
Relationship transferences (mistaking one person
for another; for example - perceiving an ex-partner as an abandoned child)
People who identify with their body may be distressed by
diabetes. Daily injections, mood swings and fears of complications may also
become a source of depression
Stress and Trauma
Stress influences the effects of diabetes. Emotional stress
leads to the secretion of many hormones that can counteract the actions of
insulin and disrupt metabolic control.
Stress-induced emotions can produce hyperglycemia,
and disrupt a person’s relationships, eating habits, exercise and
daily routines. This affects diabetes management and insulin dosage. A patient’s
emotional needs and problems are an important component of treatment and an integral
component of diabetes management. Systemic Coaching
can improve the relationship between
diabetes and life.
[ Stress ]
[ Trauma and PTSD ]
6. Relationship Coaching
As chronic high blood sugar may cause medical complications, a major goal
of diabetes management is normal blood-sugar, to balance energy expenditure with insulin dosage.
Sugar intake may invoke both historic and
systemic relationship entanglements.
Relationship Coaching supports healthy behavioral changes, such
as reducing dietary fat, increasing physical activity, and increasing
knowledge and skills.
Relationship Coaching provides possibilities
for improving relationships and emotional stability.
It helps people live full lives
by promoting emotional well being and life
activities (e.g., educational and vocational goals, recreational
activities).
NOTE: Consult a physician regarding the
applicability of any opinions or recommendations about diabetes, or any
other medical symptoms, medical diagnosis or medical conditions.
[ Relationship Coaching - A Doctor's Perspective ]
Do you want relationship coaching or systemic coach training? Do you want to coach people to resolve emotional and relationship challenges?
Copyright © Martyn Carruthers 2003, 2005,
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