For patients with diabetes, the road of glucose control is not only a physiological struggle with high blood glucose, but also a psychological game with emotional fluctuations. According to statistics, 50.1% of diabetic patients have different degrees of negative emotions, and the incidence of diabetes combined with depression is 2-3 times that of the general population. Emotional problems and hyperglycemia interact to form a vicious circle, which seriously affects the quality of life and disease prognosis of patients. Therefore, paying attention to the emotional health of diabetic patients and realizing the whole process management from “sugar” to “heart” has become an important part of the comprehensive treatment of diabetes.
1. Mechanism of bidirectional association between diabetes and mood disorders
There are complex bidirectional causal relationships between diabetes and mood disorders:
01 Direct effect of hyperglycemia on mood: Long-term hyperglycemia can cause oxidative stress and accumulation of advanced glycation end products in the body, damage small blood vessels in the brain, and lead to decreased blood perfusion in the prefrontal cortex, hippocampus and other core areas of emotion regulation. At the same time, abnormal insulin signaling pathway can affect the synthesis and transport of neurotransmitters such as serotonin and norepinephrine, and the reduction of these neurotransmitters is closely related to depressive symptoms. In addition, chronic low-grade inflammation in the diabetic state can affect the central nervous system through the blood-brain barrier, activate microglia, induce neuroinflammatory responses, and destroy the human emotional regulation network. blood glucose machine
02 The reverse effect of emotional problems on blood glucose: anxiety, tension, depression and other negative emotions will make the body in a state of stress, resulting in increased secretion of glucocorticoids, catecholamines, cortisol, growth hormone and other hypoglycemic hormones, these hormones will antagonize the action of insulin and increase blood glucose. At the same time, emotional problems can also affect patients’ self-management ability, leading to uncontrolled eating, reduced exercise, and decreased medication compliance, which further aggravates blood glucose fluctuations.
Additive effect of lifestyle and psychological stress: patients with diabetes require strict diet control, regular medication or insulin injection, and regular monitoring of blood glucose. The complexity of daily management can bring great psychological pressure to patients. In addition, fear of complications, economic burden, social discrimination and other factors can also increase the psychological burden of patients and induce or exacerbate emotional disorders.
2. Early identification and screening of emotional disorders in diabetic patients
Early identification and screening of emotional disorders in patients with diabetes is the key to effective intervention:
01 Common types of mood disorders: Common mood disorders in diabetic patients include depressive disorders, anxiety disorders, diabetes-related adjustment disorders, etc. Among them, depressive disorder is characterized by persistent low mood, loss of interest, anhedonia, sleep disorders, appetite changes, etc. Anxiety disorders were characterized by excessive worry, nervousness, palpitations, sweating, shaking hands, etc. Diabetes-related adjustment disorders manifest as emotional reactions to the diagnosis of diabetes such as denial, anger, fear, and helplessness.
Identification of hidden emotional problems: The emotional problems of some diabetic patients may be more hidden and easy to be ignored. For example, patients may be extremely tired and resistant to self-management behaviors such as blood glucose monitoring, diet control, and exercise. Feeling hopeless and giving up on the treatment results; A sudden change in appetite, sudden overeating or loss of appetite; Unexplained body pain, such as headache, back pain, stomach discomfort, etc., but the examination had no clear cause; Sleep problems, such as difficulty falling asleep, waking up early, and dreaming too much. If these symptoms persist for more than two weeks, the possibility of a mood disorder should be highly suspected.
Screening tools and methods: Commonly used mood screening tools include self-rating depression scale (SDS), self-rating anxiety scale (SAS), Patient health Questionnaire-9 (PHQ-9), Generalized anxiety Disorder scale (GAD-7), etc. These scales are simple to perform and can be rapidly screened in outpatient clinics or in the community. For patients with abnormal screening results, professional psychological evaluation and diagnosis should be further performed. In addition, doctors should pay attention to the emotional state of patients during daily diagnosis and treatment, actively ask patients about their psychological feelings, and find potential emotional problems in time. blood glucose measurement
3. Whole-process management strategies for diabetic patients’ emotional health
01 Drug therapy: two-pronged, taking into account blood glucose and mood
Selection of hypoglycemic agents: When choosing a hypoglycemic agent, the effect of the drug on mood should be considered. For example, drugs such as metformin, GLP-1 receptor agonists, and SGLT2 inhibitors not only have good hypoglycemic effects, but may also have a positive effect on mood. Studies have shown that GLP-1 receptor agonists can improve depressive symptoms by regulating the levels of neurotransmitters in the central nervous system. SGLT2 inhibitors can reduce body weight and blood pressure and improve cardiovascular function, which indirectly improves mood status.
Pharmacologic treatment of mood disorders: Patients diagnosed with depressive or anxiety disorders should be treated with antidepressants or anxiolytic drugs under the guidance of a psychiatrist. The commonly used antidepressants include selective serotonin reuptake inhibitors (SSris), serotonin and norepinephrine reuptake inhibitors (SNris), etc. Commonly used anti-anxiety drugs include benzodiazepines, buspirone, and so on. When using drugs for treatment, attention should be paid to the adverse reactions of drugs and the interaction with hypoglycemic drugs should be avoided.
02 Psychotherapy: reshaping cognition and improving mood
Cognitive Behavioral therapy (CBT) : Cognitive behavioral therapy is a common psychological treatment for diabetes-related mood disorders. It improves emotional state and self-management by helping patients identify and change negative thought patterns and behavioral habits. For example, help patients realize that “occasionally high blood glucose does not mean treatment failure” and “low mood can be improved by positive coping”, so as to reduce the patient’s psychological burden and enhance treatment confidence.
Mindfulness-based stress Reduction training: Mindfulness-based stress reduction training reduces stress and anxiety by guiding patients to pay attention to their present feelings and accept their emotional and physical states. Studies have shown that mindfulness-based stress reduction training can significantly reduce the symptoms of depression and anxiety and improve the quality of life in diabetic patients.
Supportive psychotherapy: Supportive psychotherapy helps patients relieve their psychological pressure and enhance their confidence in overcoming the disease by listening to their hearts and giving them emotional support and encouragement. Physicians, family members, and friends can all be providers of supportive psychotherapy. blood glucose meter at home
Lifestyle intervention: Start from the details to improve the physical and mental state
Moderate exercise: Exercise not only helps to control blood sugar, but also promotes the release of endorphins and other neurotransmitters in the brain to improve mood. People with diabetes are recommended to do at least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, jogging, swimming, and cycling, in combination with strength training, such as weight lifting, push-ups, and sit-ups. Exercise time should avoid fasting and immediately after meals, and it is recommended to carry out 1-2 hours after meals. Blood glucose should be monitored during exercise to avoid hypoglycemia.
Diet adjustment: A proper diet not only helps to control blood sugar, but also provides adequate nutrition for the brain and improves mood. People with diabetes should follow a low-sugar, low-fat, high-fiber diet, and increase the intake of foods rich in Omega-3 fatty acids (e.g., deep-sea fish, flaxseed, walnuts, etc.), B vitamins (e.g., whole grains, lean meats, eggs, green leafy vegetables, etc.), and tryptophan (e.g., chicken, fish, beans, nuts, etc.), which help regulate neurotransmitter levels. Improve your mood.
Regular sleep: Good sleep helps restore physical strength, regulate mood, and improve immunity. People with diabetes should maintain a regular schedule with adequate sleep of 7-8 hours per day. Avoid behaviors that interfere with sleep, such as staying up late, using electronic devices before bed, and drinking coffee or strong tea. If you have sleep problems, you should seek help from your doctor in time.
Quit smoking and limit alcohol: smoking and drinking can aggravate the condition of patients with diabetes and affect their emotional state. Smoking can damage vascular endothelial cells and increase the risk of cardiovascular disease. Alcohol consumption affects glycemic control and burdens the liver. Therefore, patients with diabetes should quit smoking and limit alcohol consumption, and maintain a healthy lifestyle.
Social support: build a network to reduce psychological isolation
Family support: The understanding and support of family members is an important guarantee for the emotional health of patients with diabetes. Family members should learn diabetes-related knowledge, understand the psychological needs of patients, and give patients emotional support and practical help. For example, help patients to make meal plans, accompany patients to exercise, remind patients to take medicine on time, etc. At the same time, family members should avoid excessive attention or neglect of the patient’s condition, and respect the patient’s feelings and choices.
Social support: all sectors of society should strengthen their attention and support for people with diabetes to reduce discrimination and prejudice. The government should increase investment in diabetes prevention and control, improve the medical security system, and reduce the economic burden of patients. Health records of diabetic patients should be established in communities, and health education and psychological support activities should be carried out. Medical institutions should strengthen multidisciplinary collaboration to provide patients with a full range of medical services. In addition, people with diabetes can participate in diabetes support groups to share experiences with other patients, encourage each other, and enhance their confidence in overcoming the disease. glucometer
4. Future prospects and challenges
With the in-depth study of the relationship between diabetes and emotional disorders, the emotional health management of diabetic patients will be paid more and more attention. In the future, we need to further explore the pathogenesis of diabetes and mood disorders, and develop more effective treatment methods and intervention strategies. Strengthen the screening and diagnosis of emotional disorders in diabetic patients, and improve the early recognition rate; To improve the social support system and provide more comprehensive psychological support and help for diabetic patients. At the same time, we also need to recognize that the emotional health management of diabetic patients is a long-term process that requires the joint efforts of patients, family members, doctors and all walks of life. Only in this way can we truly realize the whole management of diabetic patients from “sugar” to “heart” and improve the quality of life and disease prognosis of patients.
Post time: Mar-02-2026