The T1D Guide for Mental Health Care Providers


Editor’s Note: The American Diabetes Association (ADA) currently offers a “Mental Health Diabetes Education Video On-Demand Program.” After completion, participants will be eligible to apply for a listing in the ADA Mental Health Provider Referral Directory and receive a complimentary one-year associate membership.

If you’re going to be caring for a person with type 1 diabetes with regard to their mental health, there are some important things to know about the various emotional impact of having type 1 diabetes (T1D) and the many potential outcomes.

What is Type 1 diabetes?

First and foremost, it is pertinent to have a strong grasp on what exactly the disease is in order to empathize on an emotional level.

Type 1 diabetes is an autoimmune disease which happens when the body’s immune system starts attacking part of its own pancreas, destroying the insulin-producing cells. Insulin is a hormone that regulates blood sugar and without it, sugar stays in the blood and can cause serious damage to organ systems, causing people to experience diabetic ketoacidosis (DKA). Scientists have not yet identified one specific cause.

Living with T1D is a full-time balancing act requiring constant attention to avoid long-term damage done by hyperglycemia (high blood sugar) and acute, life-threatening hypoglycemia (low blood sugar).

Learn more about type 1 diabetes.

How is T1D managed?

Unlike certain cases of type 2 diabetes, people with type 1 diabetes cannot manage their condition by a simple modification in diet or exercise, or by taking a pill. People with T1D are insulin dependent, which means that they must take insulin every day to survive. This can be done a few different ways.

  • Injections with syringes
  • Injections with insulin pens
  • Insulin pumps

People with T1D must also test their blood glucose levels several times a day with a blood sugar meter, sometimes with the aid of a continuous glucose monitor (CGM) to see if they are in range.

Counting carbohydrates is a large part of T1D management. Depending on each person’s carb:insulin ratio as recommended by an endocrinologist, a person with type 1 must always calculate the amount of carbs per meal and give an insulin dose accordingly. This can at times be taxing, confusing and frustrating.

The highs & lows

People with type 1 diabetes quite commonly experience both high and low blood sugar levels due to either a lack of insulin in the body (hyperglycemia/high blood sugar), or too much insulin in the body (hypoglycemia/low blood sugar.) Both scenarios can be stressful and frightening, both physically and mentally.

  • Symptoms of high blood sugar can include: fatigue, nausea, increased thirst, confusion, headache, frequent urination
  • Symptoms of low blood sugar can include: hunger, dizziness, shaking, change in mood, rapid heartbeat, confusion, fatigue, loss of consciousness

In severe cases, if not treated, both can lead to coma or death.

Possible effects

Mental health issues that can stem from having and managing type 1 diabetes can include:

  • Depression

Managing T1D can make someone feel very isolated, misunderstood and vulnerable. The daily battles can certainly lead to sadness and an overall feeling of hopelessness.

Learn more about Depression and Its Relationship to Type 1.

  • Anxiety

High blood sugar, low blood sugar, other serious diabetes complications, and added stress as it relates to managing the disease while navigating other life concerns weigh heavy on the minds of many people with T1D, making them anxious on a daily basis.

My Balancing Act—Overcoming Type 1 Anxiety by Embracing Inner Peace by Alexi Melvin.

  • Obsessive-compulsive disorder (OCD)

Managing type 1 diabetes each day requires a great deal of attention and many factors. There are always several balls in the air, so to speak. Getting into a routine when it comes to taking insulin, testing blood sugar levels and carb counting can sometimes lead to obsessive behavior.

  • “Diabetes burnout”/Denial

Diabetes burnout occurs when managing T1D becomes too much for a person with the disease. There are so many ups and downs each day, and the struggle, at times seems more severe than others. When burnout occurs, the sense of denial experienced leads to neglect of all T1D management.

  • Diabulimia

Diabulimia is an eating disorder that some people with type 1 experience in relation to issues with body image. Not to be confused with bulimia (the eating disorder characterized by binging and purging). People suffering from diabulimia deliberately give themselves less insulin in order to lose weight. Lack of insulin causes severe high blood sugar, which then leads to weight loss (and other life-threatening complications.)

Type 1 diabetes affects those who are diagnosed in many different ways. Each day can bring new struggle and hardship, as with any disease or illness. No one person will react the same way to their daily T1D management.

This content is a part of Beyond Type 1’s guidebook, which includes guides for everyone who has a type 1 in their life. Check out the rest of our customized guides for the different people in your life here!

WRITTEN BY BT1 Editorial Team, POSTED 12/07/16, UPDATED 12/26/22

This piece was authored collaboratively by the Beyond Type 1 Editorial Team.