Preventing stress related to diabetes

Once considered a disease of the elderly, diabetes has now become an "epidemic" affecting all age groups. Not only does it cause physical harm, but it also brings with it anxiety, stress, and depression – factors that reduce adherence to treatment and trap patients in a vicious cycle from which it is difficult to escape.

The doctor is caring for a patient who has complications from diabetes.

According to the Ministry of Health , depression increases the risk of developing type 2 diabetes by 37%. Conversely, diabetes increases the risk of depression by three times, especially in those who have already developed complications, and the risk of death increases fivefold. Elderly patients with type 2 diabetes and those with complications are at high risk.

According to Dr. Pham Thi Thu Ha, Head of the Foot and Diabetes Unit, Department of Endocrinology and Diabetes (Tam Anh General Hospital), when facing a chronic disease like diabetes, feelings of anxiety, stress, fatigue, and despair easily arise. This reduces the ability to self-manage and control the disease, creating a vicious cycle of diabetes and depression. Many studies show that people with diabetes have twice the risk of depression and 20-30% higher risk of anxiety compared to those without the disease. "Diabetes stress"—that is, feelings of being overwhelmed, frustrated, and anxious due to constantly dealing with treatment—is also reported in over 40% of patients.

Although there are no official statistics, the Tam Anh General Hospital System has recorded that over 50% of diabetic patients who come for examination have signs and symptoms of anxiety, stress, and even depression, such as prolonged insomnia, sadness, gloominess, reluctance to socialize, and a desire to give up treatment. Dr. Ha said that the relationship between diabetes and mental health is two-way. When patients are stressed or depressed, they tend to adhere less to treatment, easily stop taking medication, have irregular eating habits, and check their blood sugar less frequently. This leads to an increase in HbA1c (a measure of blood sugar over three months), increasing the risk of vascular, cardiovascular, and neurological complications. This creates a vicious cycle that is difficult to break. Conversely, when the disease progresses and complications appear, patients are even more likely to fall into a state of demotivation, a lack of motivation to live, and a feeling of helplessness.

Experts cited the case of Mrs. Tinh, 68 years old, from Tay Ninh, who had diabetes for 16 years and was admitted to Tam Anh General Hospital with necrosis of her right foot, her toes gradually turning dark purple and then black, infection spreading up to her ankle, high fever, blood sugar levels four times higher than normal, and HbA1c nearly double the normal level.

The patient's children reported that since being diagnosed with diabetes, Mrs. Tinh had been constantly anxious. In recent years, as she aged, her anxiety and fear gradually increased. She became less talkative, withdrawn, limited her social interactions, became easily irritable, and no longer took care of her body as before. She often forgot to take her medication or ate erratically, not following the diet specifically for people with diabetes. Noticing these unusual signs, Dr. Ha advised the family to take Mrs. Tinh for a specialized psychological examination. The results showed that the patient was suffering from depression.

“When patients suffer from depression, the burden associated with diabetes becomes even more severe, and satisfaction with diabetes treatment is lower. Patients with depression and diabetes often engage in less physical activity, have an increased tendency to smoke, adopt unhealthy eating habits, and have poor treatment adherence, leading to an increased risk of dangerous health complications. Worryingly, over 50% of cases of depression in diabetes go undiagnosed,” Dr. Ha warned.

Because the initial symptoms are quite general and vague, such as fatigue, weight loss or gain, changes in appetite, sleep disturbances, etc., patients do not recognize the signs of depression themselves, or even if they do, they rarely inform their doctor. According to this expert, the rate of anxiety disorders and eating problems is also higher in diabetic patients compared to healthy individuals. Therefore, early diagnosis and treatment of depression in diabetic patients is very important.

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