What is diabetic distress?

Diabetic distress can cause someone to just give up on managing their blood sugar levels. (This visual is human-created, AI-aided)

My friend has uncontrolled diabetes, so I went with her to see an endocrinologist. My friend is very careful about her diet. She checks every-thing she eats, is on a continuous glucose monitoring (CGM) device, and worries about why her sugar is spiking at certain times of the day. The endocrinologist calls this “diabetic distress”. I have never heard of such a term before. What is it?

Diabetic distress is the negative emotional experience or state that is caused by the challenges of living with diabetes.

Unfortunately, many doctors do not screen for it nor treat it.

It can affect a diabetic patient terribly.

As many as one out of every three diabetics have diabetic distress, according to a study published in 2024.

So it is an emotional state? Like feelings?

Yes. It is a psychological state.

Every day, a diabetic patient, or even pre-diabetic patient (!), has thoughts, fears and anxiety about their diabetes and its possible complications.

They also have to continually make decisions related to their condition.

So, in addition to a normal person’s thoughts, worries and anxiety about everyday living, a diabetic patient has to make up to 180 extra diabetic-related decisions a day!

How can this happen?

If you have diabetes, managing it can be a full-time job in itself.

This is especially true if you are a person who is generally more concerned about your health, as opposed to a person who is more laissez faire (has a hands-off attitude).

If you are a diabetic patient who is concerned about your health and the possible future complications of what diabetes can do to your body over the long term if it is massively uncontrolled (e.g. kidney failure, heart disease, stroke, blindness, gangrene, etc), you could be quite obsessive about doing the following:

> Checking your blood glucose levels very regularly

Some diabetic patients I know put themselves on a CGM device that is linked to an app on their phone.

Then they religiously check it every hour.

“Oh no, my sugar is high after I ate that white rice!” is a common complaint you hear from them.

Or “Oh no, my sugar didn’t dip down to normal after that meal. It means I may have to up my meds!”.

Every meal, they find themselves thinking thoughts like “Should I eat this?”, “No, I really shouldn’t have that slice of birthday cake” or “Will this nasi lemak make my blood sugar spike?”.

> Taking your medications every day

Diabetic patients tend to be have that triumvirate of diseases that affect many Malaysians: high blood pressure and high cholesterol, in addition to high blood sugar.

Throw in obesity, and you have four medical conditions to worry about and their accompanying medications to remember to take!

> Managing your time to allow for sufficient exercising

You have to think about exercising if you are actively trying to manage your blood sugar.

This is a good thing, but you still have to actively schedule it.

Some people even worry about when and how to get their daily exercise in.

Add all this to your daily worries, and you may get a fullblown burnout!

What is the difference between diabetic distress and normal diabetic worries? When do you know that you have tipped into the “distress” zone?

Diabetic distress happens when worries and concerns about their diabetes affect the patient so much that it starts to impact their daily life.

Diabetic distress symptoms can look like this:

• Feeling angry that you have diabetes in your life and having to manage it
• Worrying that you are not doing enough to take care of your diabetes, but are not motivated enough to make changes in your life
• No longer feel like checking your blood sugar or going for your doctor appointments (because you are afraid of knowing the truth about your diabetes!)
• “Giving up” on your diet and purposefully making unhealthy food choices because you are so fed up of living a certain way
• Feeling that you are all alone with your disease and no one understands what it’s like to be you.

If you think you have tipped over into the diabetes distress zone, tell your endocrinologist.

They are trained to look out for this and help you accordingly.

Is diabetic distress also known as diabetic burnout?

No, burnout is a more advanced state.

In diabetic burnout, you feel disillusioned, frustrated and as though everything is too much for you to cope with.

It may be reached after many years of dealing with diabetes.

So you may experience:

• Strong negative feelings like being overwhelmed or angry

   

  These feelings are stronger than the ones experienced in diabetic distress.

• Feeling like you are being controlled by your diabetes
• Avoiding all or some part of managing your diabetes

   

  For example, you no longer want to take your medications.

  Sometimes, you purposefully skip your medications or take lower doses of what you should be taking.

Sometimes, diabetic burnout can have triggers.

This could be a stressful event that happened in your family (e.g. a death) that makes your diabetes feel unimportant.

Or you develop a new diabetic complication despite years of trying to manage your diabetes.

Then you end up frustrated and wondering what’s the point of all your hard work.

See Tell Me About in StarLifestyle on July 6 (2026) for what you can do about your diabetic distress.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.