Managing diabetes can be stressful, and variations in blood sugar levels may also contribute to mood changes. These factors may place a strain on relationships.

Diabetes impairs the body’s ability to use blood glucose. The most common types are type 1 and type 2.

To help manage this condition and keep blood sugar in a target range, people with diabetes typically need to follow a strict routine that involves medical treatments, a certain diet, and physical exercise.

Controlling diabetes can be overwhelming and may negatively affect emotional and mental health. Plus, in addition to causing a range of physical symptoms, having hyperglycemic or hypoglycemic episodes can also impact a person’s mood and thinking.

All of these factors may be difficult to navigate and strain relationships. But learning about these effects of diabetes can help a person with the condition, and the people around them, build stronger, healthier relationships.

This article will explore the effects of diabetes on mood and relationships in more detail.

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Research has provided mixed results, but some evidence indicates a potential relationship between mood and blood sugar. Fluctuations in blood sugar, whether high or low, may cause a person to experience a variety of serious symptoms, which can include changes in mood.

The symptoms of low blood sugar that may affect a person’s mood include:

  • confusion
  • nervousness or anxiety
  • hunger
  • difficulties with coordination, concentration, and decision making
  • aggression, irritability, and impatience
  • personality and behavioral changes

Having high blood sugar may also cause symptoms that can affect mood, such as:

  • difficulty seeing or concentrating
  • feeling unwell
  • feeling tired or having low energy

Moreover, during periods of stress, the body releases the hormone adrenaline. The body may also release adrenaline to help recover from an episode of low blood sugar.

The release can bring about a fight-or-flight state known as an adrenaline rush. When the body triggers this response, it can cause:

  • heightened awareness
  • dizziness
  • lightheadedness
  • vision changes
  • restlessness
  • irritability
  • a nervous, jittery sensation

While blood sugar can affect mood, a person’s mood may also affect their blood sugar levels.

A pre-print paper from 2020 describes research indicating that mood and stress can significantly influence blood glucose levels and glycemic variability, or fluctuations in blood sugar levels. However, as a 2021 systematic review points out, understanding the relationship requires more research.

Having diabetes can lead to what some people call diabetes distress. This stress response may stem from the burden of managing diabetes every day. Some people call this “diabetes-specific” distress or “diabetes-related” distress.

Evidence suggests that this may affect:

  • 1 in 4 people with type 1 diabetes
  • 1 in 5 people with insulin-dependent type 2 diabetes
  • 1 in 6 people with non-insulin-dependent type 2 diabetes

A doctor may use the Problem Areas In Diabetes scale and the Diabetes Distress Scales to help identify the condition and guide conversations and care.

Potential symptoms of diabetes distress include:

  • anger and frustration about the demanding nature of the condition
  • worry about being able to manage it
  • a low level of motivation to manage the condition
  • avoiding appointments or checking blood sugar levels
  • making unhealthy choices
  • feeling isolated

The symptoms of diabetes distress may overlap with those of some other mental health conditions, but they are distinct and require different assessments and management strategies.

Diabetes distress stems from factors that relate to diabetes. As such, medications cannot typically treat it. Improving the diabetes management plan and attending therapy may help reduce the symptoms and underlying stress.

People may also experience “diabetes burnout.” This refers to physical or emotional exhaustion that results from continuous distress related to diabetes management.

A person may feel that despite their best efforts, they are unable to control their blood glucose, leading to a sense of powerlessness. This can negatively affect their management of the condition and their health.

Symptoms of diabetes burnout include:

  • disengagement from self-care
  • uncontrolled or unhealthy eating
  • risk-taking behaviors
  • not attending appointments

People with diabetes have an increased risk of depression. Because managing the condition typically involves lifestyle changes and added responsibilities, people may find it burdensome and emotionally draining.

People with diabetes are 2 to 3 times more likely to have depression. However, it can be difficult to detect and diagnose depression in people with diabetes. For this reason, it is advisable for people to have regular mental health screenings during their visits to a doctor.

Some symptoms of depression include:

  • lack of interest in activities
  • changes in sleep patterns
  • sleep disturbances
  • changes in appetite
  • trouble concentrating
  • a loss of energy
  • nervousness
  • guilt
  • feelings of sadness, emptiness, or both
  • suicidal thoughts

Depression may appear differently in teenagers, and it may cause:

  • declining school performance
  • withdrawing from friends and activities
  • anger, agitation, and irritability

Like diabetes, depression is treatable. Having both conditions does not make one of them less treatable.

A member of a diabetes care team may refer a person to a mental health specialist, who can help create a treatment plan. This plan may include therapy, medications, and stress management.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Anxiety disorders are a group of mental health conditions that can cause persistent feelings of nervousness and worry.

Managing a long-term condition, such as diabetes, can be a major source of anxiety. Experiencing anxiety can affect a person’s diabetes self-management. Some evidence suggests that having one condition — diabetes or anxiety — may increase the risk of developing the other.

Moderate to severe symptoms of anxiety can affect 1 in 5 people with insulin-treated type 2 diabetes, non-insulin-dependent type 2 diabetes, and type 1 diabetes.

It can be difficult to diagnose anxiety disorders because people may mistake the symptoms for those of hypoglycemia. Anxiety symptoms vary, but they include excessive, persistent worry, panic attacks, irritability, confusion, sweating, and disrupted sleep.

Potential treatments include therapy, medications, and strategies such as staying physically active, practicing relaxation techniques, and taking steps to improve sleep.

Learn more about diabetes and anxiety here.

Having type 1 or type 2 diabetes may place strain on relationships due to the factors we describe above. Also, having any chronic condition can increase the need for emotional support and the potential for frustration and tension, which can lead to conflict.

Understanding the range of potential effects of diabetes can help loved ones provide support and strengthen the relationship.

A 2020 study highlights the effects of spousal influence on diabetes management and health behavior. This emphasizes the roles that healthy intimate relationships can play in self-care and improving diabetes outcomes.

Diabetes can also impact a person’s sex life. Possible complications include erectile dysfunction, vaginal dryness, and a lower sex drive. Communication is essential. Discussing any sexual effects and finding ways to work with them together can help.

A person with diabetes and their loved ones may benefit from strategies such as:

  • Paying attention to feelings: Regularly experiencing frustration and stress may suggest that a person needs more help managing their condition.
  • Talking about feelings and concerns: Members of a healthcare team, friends, and family may be able to help. They may, for example, think about ways to manage feelings of judgment.
  • Allowing loved ones to help: A person does not need to bear all the responsibilities of managing diabetes alone. Those closest to them can help remind them to take medications, monitor their blood glucose, and do physical activities together.
  • Talking to others with diabetes: Others with diabetes are likely to understand and may provide helpful advice.
  • Doing one thing at a time: To reduce stress, people may benefit from making a list of tasks and working through each point individually. This can also help a person recognize which tasks are more immediate and which ones they can do in time.
  • Taking time out for fun: It is important to set aside time to enjoy activities.
  • Asking for help: Healthcare professionals may be able to connect people with programs that help cover the costs of diabetes care medications and supplies.

If a person notices rapid fluctuations in their mood or any other symptoms that may indicate a mental health condition, it is advisable to contact a doctor.

A healthcare professional can review a person’s diabetes management plan and recommend tips or different medications. They may also be able to diagnose a mental health condition and suggest appropriate treatment or issue a referral to a doctor who can.

A person should seek immediate medical attention or call 911 if they or someone they know is experiencing suicidal thoughts or thoughts of self-harm.

Diabetes is a chronic condition that can affect both physical and mental health.

Fluctuations in blood sugar may lead to rapid changes in mood, for example. Additionally, a person may find managing diabetes every day overwhelming, and this stress can have various effects on mental health.

By learning how diabetes may affect relationships, loved ones can provide support. Encouraging communication is key.