Living with diabetes is not just a matter of managing blood glucose—it is a daily, often invisible, mental load. From the moment of diagnosis, people living with the condition face complex routines and make consequential decisions about their health while all the time carrying the emotional weight of potential complications, stigma and isolation. In clinical settings this is known as diabetes distress. Yet despite growing recognition of its impact, mental health remains a neglected pillar in diabetes care.
A 2024 International Diabetes Federation global survey revealed that 3 in 4 people with diabetes have experienced anxiety and depression as a result of their condition. Yet, diabetes care often focuses only on blood glucose levels and treating complications once they appear. The mental and emotional needs of people are left by the wayside.
Healthcare providers may not always recognise just how challenging it can be to manage both diabetes and mental health. Each can have a profound impact on the other. That relationship is often shaped by cultural context and wider systemic factors. Clinical experience and lived perspectives alike show that diabetes distress can manifest in many emotional forms, influencing everything from blood glucose control to daily self-management. The overwhelming impact can lead to diabetes burnout and abandonment of care plans.
How people understand their condition—through personal beliefs, emotional responses, and meaning-making—also impacts how they cope. By paying attention to these deeper layers, healthcare professionals can offer care that responds not just to physical needs but to the whole emotional reality of life with diabetes. As research, lived experience, and advocacy increasingly show, genuine diabetes care must address the mind as much as the body—because emotional well-being is not a luxury; it’s a necessity.
In an international study, researchers from Czechia, the University of Cambridge, and the MRC Biostatistics Unit uncovered a troubling trend. Children diagnosed with type 1 diabetes face a greater risk of developing mental health conditions — including mood and anxiety disorders. About half mentioned they need help dealing with the emotional side of things. These numbers make one thing clear: people living with diabetes need care that looks after both their body and their mind.
How people understand their condition—through personal beliefs, emotional responses, and meaning-making—also impacts how they cope
Diabetes distress is not a psychiatric disorder but a spectrum of emotional responses unique to living with diabetes.
A session at the recent International Diabetes Federation (IDF) World Diabetes Congress 2025 in Bangkok looked at the effects of diabetes on mental health. Clinical psychologist Mr Naser Altooblani (Bahrain) explained that existing models of diabetes distress are often too linear. “They assume diabetes alone leads to distress,” he noted, “but distress is rarely the product of diabetes in isolation.”
In a clinical vignette, he described working with Kareem, a 17-year-old facing depression, suicidal ideation and not following treatment. Kareem’s emotional challenges were shaped not only by diabetes but also by childhood trauma, structural instability, and social dynamics—all interacting in complex ways.
Studies confirm that many factors contribute to the experience. A 2024 study on lived experiences of diabetes distress found that up to 40% of adults with type 1 diabetes and 35% of those with type 2 experience significant psychological distress, with contributing factors ranging from health anxieties to socioeconomic deprivation.
Working with people in low-resourced settings gave Naser firsthand insight into the mental distress caused by insulin rationing. Due to the high cost of insulin and the absence of universal health coverage, many are forced to go without treatment for several days at a time. The experience underscored not only the physical dangers of disrupted care but also the heavy emotional burden it places on people simply trying to stay alive.
Ms Amanda Rydén, president of Young Diabetes Sweden, highlighted the acute mental health toll on young people. A 2024 survey by her organisation found that nearly two-thirds of youth reported negative impacts on mental well-being from diabetes. Among women, 71% reported thinking about their diabetes at least once an hour. Many described feeling unseen by their healthcare providers and isolated in their experience.
Amanda’s presentation echoes what many young people report worldwide: transitioning into adulthood with diabetes is fraught. “My diagnosis came when life was hectic,” she recalled. “I thought I could handle it alone—but connecting with others who understood what I was going through changed everything.”
Research supports this need for connection. Peer support can reduce diabetes-related distress and improve self-management. Yet, healthcare systems often fail to integrate peer programmes or youth-focused mental health pathways into standard care.
In low-resourced settings, the high cost of insulin and the absence of universal health coverage forces many to go without treatment for several days at a time, causing a heavy emotional burden
Perhaps one of the most pervasive mental health burdens is stigma. Ms Lucia Feito Allonca, (Spain) a lived experience advocate and speaker at the session, described stigma as “a shadow that follows you everywhere.” It arises from media portrayals, public misconceptions, and even interactions with healthcare providers—and is often internalised by people living with diabetes. The consequences? Shame, secrecy, skipped treatments, and poorer health outcomes.
An international consensus published in 2023 sought to end diabetes stigma and discrimination. Outcomes found that four in five adults with diabetes experience stigma and one in five face outright discrimination. The consensus calls for respectful and inclusive language, as well as better representation of people living with diabetes in public discourse.
Language matters. As Lucia emphasised, “I am a person living with diabetes—not a diabetic.” Words shape perception, and perception shapes care. The “No Diabetes Stigma” pledge—launched globally—urges healthcare providers, organisations, and individuals to commit to non-judgmental, person-first approaches.
Diabetes technology, from insulin pumps to continuous glucose monitors (CGMs), has transformed care, but it can also increase mental burden. Dr Katherine Barnard-Kelly (UK), another session speaker, urged providers to weigh the benefits and drawbacks.
“Technology increases visibility,” she noted. “For some, this brings safety. For others, it is a constant reminder of their condition.” Alarms can trigger anxiety, data-sharing can feel intrusive, and over-monitoring may promote perfectionism or burnout.
Despite the potential, access to technology is unequal, often influenced by socioeconomic status, health literacy or healthcare provider bias. As Professor Kelly stressed, access needs to be equitable, with choices shaped by the needs of the person living with diabetes—not by assumptions.
One of the most pervasive mental health burdens is stigma, which can lead to shame, secrecy, skipped treatments, and poorer health outcomes
Speakers at the congress stressed that focusing solely on coping strategies—”breathe through your distress”—is insufficient. Mental health support must be structurally competent, which means acknowledging and addressing the social determinants of health: poverty, access to medication, family dynamics, and systemic inequality.
“Too often, therapy starts without asking: what are you facing?” said Naser Altooblani . “Are your basic needs met? Do you have access to insulin? These questions are foundational.”
This message resonates especially in low- and middle-income countries, where structural challenges are acute. One attendee from South Africa described how a single camp experience transformed the life of a suicidal teen simply by offering support and connection—a powerful reminder that community-led solutions are not secondary but essential.
How can healthcare providers effectively incorporate mental health into diabetes care? Outcomes from the IDF congress session may provide part of the answers, starting with a set of clear and practical recommendations to place mental health at the heart of diabetes care.
Every diabetes clinic should include psychological expertise—not as an add-on, but as an integral part of care. Healthcare providers must go beyond numbers, asking “How are you?” as routinely as they ask about blood glucose. Fixing the bigger systemic issues is just as important. That includes making it easier to transition from care in childhood to care as an adult. It also means reducing costs and tackling stigma in healthcare settings.
Mental health support must be structurally competent, which means acknowledging and addressing the social determinants of health
Integrated and fully funded peer support needs to be part of the solution, too—especially for young people and those in low-resourced communities. Finally, checking psychosocial well-being should be just as regular and rigorous as checking HbA1c. Implementing these measures requires commitment, but the rewards are substantial: more responsive healthcare, improved emotional well-being, and better long-term outcomes for people living with diabetes.
The mental health of people living with diabetes is inseparable from their physical care. It is not a luxury nor a niche concern. It is central to living well with diabetes, and its absence comes at a high cost.
As the IDF congress session made clear, we must truly listen to those with lived experience. We must understand that stigma, structural barriers, and emotional exhaustion are not side issues but central challenges. And we must act collectively to ensure that every person living with diabetes has access to compassionate, comprehensive mental health support.
Because when we care for the whole person, not just the numbers, we change lives.
What’s the connection between mental well-being and diabetes management? In this episode of D-Talk dedicated to the World Diabetes Day theme: Diabetes and well-being, host Phyllisa Deroze is joined by three inspirational diabetes advocates, Thapi Semenya, Naser Altooblani and Bruno Helman. They explore how untreated mental health issues can worsen diabetes outcomes and how the pressures of diabetes management can affect mental well-being.
