Key takeaways:
Diabetes distress is a common emotional response to the daily stressors of managing diabetes.
Diabetes distress can cause many bothersome symptoms, including feelings of frustration, burnout, and stress.
If you have symptoms of diabetes distress, reach out to your diabetes care team. Certain feelings can be overwhelming, and they may not go away on their own without support.
For people living with diabetes, there are days when it’s hard to maintain a positive outlook on life. Even when you do everything right, your blood sugar (glucose) may not reflect your efforts. This is why diabetes distress — an emotional response to the daily demands of managing diabetes — is very common. Research suggests that 30% to 40% of adults living with diabetes experience diabetes distress.
Here’s the thing: Your thoughts can affect how you feel and act. By challenging negative thinking about diabetes, you can explore helpful alternatives. Let’s dive in.
What is diabetes distress?
Diabetes distress, or diabetes-related distress, is an emotional response to the daily demands and struggles of diabetes. Diabetes distress is an experience that people with all types of diabetes share, across all cultures and age groups.
Researchers have been using the term “diabetes distress” since the 1990s. However, the American Psychological Association (APA) doesn’t recognize it as an official diagnosis. This is because diabetes distress isn’t classified as a mental illness. Rather, it’s seen as an emotional response to the stress of managing diabetes.
Despite this, there’s evidence to suggest that diabetes distress can affect a person’s emotional and physical well-being. This is why your healthcare team may monitor for symptoms of diabetes distress at your regular appointments. And it’s why the 2026 American Diabetes Association (ADA) “Standards of Care” recommends screening for diabetes distress regularly and referral to a mental health professional if needed.
You may also have regular screening for depression, anxiety, and eating disorders, since these are all more common in people with diabetes.
Symptoms of diabetes distress
Symptoms of diabetes distress can range from mild to severe, and they can be different for each person. While it’s normal to feel frustrated with diabetes, these feelings shouldn’t be overwhelming or relentless.
You may have diabetes distress if you have diabetes and on most days feel any of the following:
Overburdened by diabetes management
Overwhelmed by fears and worries about diabetes-related health problems or severe low blood glucose (hypoglycemia)
Defeated, discouraged, or burned out by daily diabetes tasks or when not meeting goals
Depression or anxiety about managing your diabetes
Withdrawal from social activities or relationships
Feeling powerless or out of control about treating your diabetes
If you’re regularly noticing any of these symptoms, be sure to let a healthcare professional know.
This diabetes distress assessment tool can help you identify the level of diabetes distress you may have: low, moderate, or high. That way, you can figure out your next steps (more on this below).
What causes diabetes distress?
The most common cause of diabetes-related worries and stress are round-the-clock diabetes tasks paired with fear of disease-related problems. Having diabetes that’s hard to manage can make things worse. But even people with an in-range hemoglobin A1C (HbA1C or A1C) can experience significant diabetes distress.
Wearable technology can help people better manage their diabetes. But this technology can also add to the emotional burden of living with diabetes in different ways, such as:
Maintaining devices and needing to remember to wear them
Alarm fatigue
Information overload
Financial stress of device and supply costs
Certain stressful life events can tip people over the edge too. Just because you’ve managed your diabetes well in the past doesn’t mean you’re immune to diabetes distress in the future.
Life changes can make you feel overwhelmed when you’re living with a lifelong condition like diabetes. These include:
Changes in life circumstances, like the loss of a job or a relationship breakdown
Health complications
Changes to diabetes treatment
How do you manage diabetes distress?
Living with diabetes is hard. Emotional effects from the daily demands of diabetes have a way of sneaking up on everyone, including caregivers. Here are some tips:
Pay attention to your feelings. Honor them and notice if they hang around for more than a week.
Be honest with your support network. Share your feelings with others you trust, and don’t put off asking for help.
Get professional help. Your healthcare team will be familiar with diabetes distress. They can help you problem-solve and find the help you need.
Engage in medication and lifestyle management. Small changes in medication, nutrition, or activity can ease daily strain.
Learn as much as you can. Diabetes education can give you clearer expectations and practical skills, making day-to-day care feel more doable.
Take one step at a time. With the support of others, you can create a plan to manage diabetes without it crushing your mental health. Even small steps can lead to big changes.
Does diabetes distress worsen the effects of diabetes on your health?
Yes. Diabetes distress can affect how someone cares for their diabetes-related needs.
Research shows a direct connection between diabetes distress and disease management.
In general, the greater someone’s diabetes distress, the higher (worse) their hemoglobin A1C.
Going beyond A1C results, research suggests that diabetes distress also affects:
Quality of life
The number of hypoglycemia events (low blood glucose)
The ability to prioritize healthy living habits (food choices, activity, and quality sleep)
How does stress (and distress) affect blood sugar?
More research is needed to understand exactly how stress worsens blood sugar levels in diabetes. But it’s likely linked to levels of stress hormones and inflammation in the body.
Can diabetes stress lead to depression?
Diabetes distress and depression aren’t the same thing. But, without treatment, diabetes distress can lead to depression.
People living with diabetes are two to three times more likely to have depression than others. But less than half of these people will be diagnosed and receive treatment for depression.
If you think you have depression, reach out to those who support you — including your healthcare team. Common symptoms of depression include:
Loss of interest or joy in doing most things
Feelings of sadness, hopelessness, or emptiness
Increased irritability and guilt
Poor sleep, energy, and appetite
Trouble with concentration
Thoughts of death or suicide
If you’re having thoughts of suicide, help is available. Call the National Suicide Prevention Lifeline at 988 or text HOME to 741-741 to reach the Crisis Text Line.
When should you get help about diabetes distress?
It’s never too early to talk to your healthcare team about the way you’re feeling. While it can be hard to reach out, know that your fears and worries are valid. By sharing your feelings in a safe space, you can get the support you need.
Until recently, the emotional weight of chronic disease wasn’t a common topic during health checkups. Diabetes distress is finally getting the recognition it needs by health experts.
With standardized tools in place, professionals can screen for diabetes distress more efficiently and regularly. Two common tools include:
Once your diabetes care team is aware, they’ll help you get any support you need. You can also discover ways to manage your diabetes together to lessen the burden.
Resources and support for healthy coping with diabetes distress
Take action if you notice symptoms of diabetes distress. Reach out to those who support you. This includes friends, family, healthcare professionals, and others. When you’re feeling overwhelmed, it can be hard to share your thoughts with others. But sharing can help to reduce the weight of what you’ve been carrying on your own.
Connecting with others who live with diabetes can also be incredibly helpful. Start with this resource list to reach out to your online diabetes community.
Sometimes, it’s best to speak with a healthcare professional about your feelings and struggles. There are resources in place to make this process easier for you:
The American Diabetes Association paired with the American Psychological Association and created a directory of healthcare professionals who are trained to support the mental health of those living with diabetes.
This online portal organized by Breakthrough T1D has links to diabetes-related guidance and support that you may need. You’re only a click away.
Frequently asked questions
Stress doesn’t directly cause diabetes, but studies show that long-term stress can actually make the body more resistant to insulin. For people already at risk because of genetics, weight, or other factors, it’s possible that this can make diabetes more likely to develop over time.
Stress itself doesn’t cause low blood sugar. But stress can lead to changes in your routine, like eating less, delaying meals, or even misjudging medication doses. These kinds of behavioral changes make low blood sugars more likely, especially for people taking insulin or other glucose-lowering medications.
Yes. There’s evidence that stress prompts the body to release hormones like cortisol and adrenaline, which can raise blood sugar. In people with Type 2 diabetes, these stress-related spikes can be more pronounced because the body already has trouble responding to insulin.
Stress doesn’t directly cause diabetes, but studies show that long-term stress can actually make the body more resistant to insulin. For people already at risk because of genetics, weight, or other factors, it’s possible that this can make diabetes more likely to develop over time.
Stress itself doesn’t cause low blood sugar. But stress can lead to changes in your routine, like eating less, delaying meals, or even misjudging medication doses. These kinds of behavioral changes make low blood sugars more likely, especially for people taking insulin or other glucose-lowering medications.
Yes. There’s evidence that stress prompts the body to release hormones like cortisol and adrenaline, which can raise blood sugar. In people with Type 2 diabetes, these stress-related spikes can be more pronounced because the body already has trouble responding to insulin.
The bottom line
Diabetes distress is a common emotional response to the daily stressors of managing diabetes. It can happen to anyone — at any time in their diabetes journey — whether you’re new to diabetes or a seasoned pro. Diabetes distress can leave you feeling frustrated, burned out, and stressed. In turn, these feelings can take their toll on your overall physical health and well-being.
If you have symptoms of diabetes distress, reach out to your diabetes care team. Certain feelings can be overwhelming, and they may not go away on their own without support. But with new screening tools and community resources, you can find the support you need and deserve.
Why trust our experts?
References
988 Suicide & Crisis Lifeline. (n.d.). Home.
American Association of Clinical Endocrinology. (n.d.). Patient support groups.
American Diabetes Association. (n.d.). Chapter 3: Diabetes distress.
American Diabetes Association. (n.d.). Mental health professional directory listing.
American Diabetes Association. (2020). Anxiety disorders.
American Diabetes Association. (2021). Problem areas in diabetes (PAID) scale.
American Diabetes Association. (2026). Summary of revisions: Standards of care in diabetes—2026. Diabetes Care.
Breakthrough T1D. (n.d.). Support team guidance.
Breakthrough T1D. (n.d.). Anxiety, depression, distress, and burnout.
Centers for Disease Control and Prevention. (2024). Diabetes and mental health.
Crisis Text Line. (n.d.). Home.
Diabetes Distress Assessment and Resource Center. (n.d.). Take the diabetes distress survey.
DiabetesEd.net. (n.d.). The diabetes distress screening scale.
Fayed, A., et al. (2022). Relation between diabetes related distress and glycemic control: The mediating effect of adherence to treatment. Primary Care Diabetes.
National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Diabetes distress and depression.
Schrems, E., et al. (2025). Daily life stress is linked to increased glucose levels in individuals with insulin resistance: A real-world assessment. Diabetologia.
Skinner, T. C., et al. (2020). Twenty-five years of diabetes distress research. Diabetic Medicine.
Yan, Y. X., et al. (2016). Investigation of the relationship between chronic stress and insulin resistance in a Chinese population. Journal of Epidemiology.
