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Emotional Diabetes

We think about controlling our diabetes with diet and exercise and usually with medication too. Seldom do we even consider the fourth leg.

But a study published in the latest issue of the Annals of Behavioral Medicine and a forthcoming one by a Ph.D. student who just wrote me emphasizes the importance of our emotions for controlling our diabetes. Emotional health and diabetes health are a two-way street — a bidirectional relationship. When our emotional level is positive, we can more easily control our diabetes. And when we control our diabetes, we feel better.

The new study focused on teens with type 1 diabetes. It suggests that negative emotions like anger or sadness interferes with their management of diabetes.

This doesn’t surprise me one bit. What is surprising is that this is the first study that I know of actually demonstrating the link between emotion and control.

The study had 62 adolescents with type 1 diabetes complete daily diaries for two weeks. These diaries detailed their mood, average blood glucose levels, overall confidence in their ability to manage their diabetes, and their ability to manage daily diabetes tasks, such as eating healthy foods and taking insulin.

When teens reported more positive feelings, such as happiness or excitement, they tended to have lower — in fact near normal — blood glucose levels. But when they reported having negative feelings, their daily diary entries revealed a tendency toward higher blood glucose levels.

The researchers measured positive and negative emotions on a one- to five-point scale. “The important issue is that for every one-point change in emotion, there is a rather sizable change in blood glucose,” says Cynthia Berg, one of the study’s co-authors from the University of Utah’s department of psychology.

The study’s abstract, “Adolescents dealing with type 1 diabetes experience disruptions in affect and diabetes management that may influence their blood glucose,” is online. It came out this month in the Annals of Behavioral Medicine, and The Center for the Advancement of Health sent me the full-text.

The forthcoming study of the emotional connection with diabetes will be the doctoral dissertation by Greg Waitkoff at Argosy University in Chicago. “Unfortunately the psychological literature on diabetes is extremely sparse, and I’m hoping that my study could add to this base in a new way,” he tells me.

Greg also has diabetes. He is seeking people with either type 1 or type 2 diabetes between 18 and 60 to participate in his research study.

This study seeks to understand the emotional effects of diabetes at the time of diagnosis. Participation in this study will require approximately 30 minutes of your time, Greg says. Participants will be asked to complete four questionnaires. Those who are interested in completing the survey through the mail should contact Greg at [email protected] or at (773) 531-2646 to receive a packet and pre-paid envelope for return. Those who are interested in completing the survey online should visit this website.

This new research brings a new dimension to the existing literature on the emotional aspects of diabetes. That literature is mostly anecdotal, and to my knowledge is contained in four important books.

Mind-Body Diabetes Revolution by Richard Surwit deals first with stress, which can raise blood glucose and may well be the most important mental factor. The other two subjects are depression and hostility, including cynicism, anger, and aggression.

The other excellent books dealing with diabetes and our emotions are Diabetes Burnout: What To Do When You Can’t Take It Anymore by William H. Polonsky and Psyching Out Diabetes: A Positive Approach to Your Negative Emotions by Richard L. Rubin and my old friends June Biermann and Barbara Toohey.

For me the most moving book about teenagers dealing with diabetes is the memoir Needles by Andie Dominick. Anyone who has type 2 diabetes and finds that condition hard to handle might want to read how difficult managing diabetes can be for a teenager. If you ever doubt that emotions are one of the legs by which we control our diabetes, you would be well advised to read any and all of these four books.

This article is based on an earlier version of my article published by HealthCentral.

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