Toxic Relationships + Type 1 Diabetes

Sensitive Topic Warning: If you are a victim of domestic violence, call the National Domestic Violence Hotline at 1-800-799-7233. Support is available to you, and you do not have to stay in the situation you are in. For this article and to protect the privacy of our community members, respondents’ names have been replaced with aliases.

Toxic relationships mean different things to different people, including those with type 1 diabetes (T1D). At the worst, a toxic relationship may involve emotional or physical abuse. Domestic violence in a relationship must be taken seriously, and the people in it should be separated. The victim of such violence should be supported and protected, and if they have a chronic illness like T1D, obtaining support can be even more urgent.

At lower levels, a toxic relationship may involve mistreating one another, growing apart, refusing to put in the effort or a lack of presence and intentionality toward each other. While domestic violence may not be involved at this level, that doesn’t mean these issues aren’t worth addressing or evaluating. It could still mean the situation you’re in is toxic. 

Not all toxic relationships involve abuse. Admitting a relationship is not serving you is brave and important. It’s the first step to healing and getting away from a toxic situation.

Toxic relationships with T1D aren’t always about the disease

First, just because you live with T1D doesn’t mean the toxic parts of your relationship are always tied to it. At a foundational level, a toxic relationship is one that doesn’t consistently serve you. Relationships aren’t perfect. You will have ups and downs, but if you notice the following signs, it may be time to re-evaluate.

General signs of a toxic relationship include:

• Feeling demeaned, attacked, unsupported or misunderstood
• Feeling psychologically, emotionally or physically threatened
• Poor self-esteem or low self-confidence
• Bringing out the worst in each other
• Feeling defensive or angry each time you speak
• Unmet needs

“That’s what’s tricky about relationships—no one can tell you what to do because no two relationship guidebooks are the same,” says Greta, a woman living with T1D who left a toxic relationship. “I may want something totally different than someone else. And guess what? Only I know that and can express it. Being human is hard. Being a human with T1D? That’s a whole other situation, especially in how it shows up in our relationships. I didn’t know what I should expect or what I could ask for.”

Greta says some parts of her toxic relationship were directly related to T1D, but most weren’t. Still, her T1D suffered because of it.

“I feel like I woke up one day and the blinders were off,” Greta says. “I needed to leave, but I had told myself it wasn’t bad enough along the way. I wish I hadn’t reinforced that idea so much, but it needed to happen on my own time.”

Cinema and news reports often imply that a relationship must reach the highest level of “bad enough” to signal it’s time to end it. But this is often a false narrative we tell ourselves to stay comfortable. It’s the main reason people don’t leave toxic relationships—the unknown is scarier than the predictable discomforts we find ourselves in.

Sometimes, we don’t even realize how much we’ve lost ourselves or how it’s affected our chronic illnesses until we’re completely out of it. Your relationship should fill your cup more days than it empties it.

How T1D suffers in a toxic relationship

Whether your toxic relationship is directly related to T1D or not, many people going through one often find that it affects their T1D. How can it not when everything else does? 

If your relationship is toxic, you may notice any of the following showing up:

• Control disguised as “concern”: Your partner is constantly monitoring your blood sugar levels without your request, questioning all your food choices, demanding access to your diabetes data or treating you like a child rather than a partner because of your condition. 
• T1D gaslighting: Your partner is minimizing the physical or emotional burden of T1D, suggesting you’re exaggerating your T1D-related concerns or dismissing them altogether.
• Weaponizing diabetes: Your partner uses your diabetes to dismiss your feelings or blames your blood sugar whenever you express negative feelings toward them.
• Lack of support in diabetes emergencies: Your partner doesn’t take your low blood sugar seriously, doesn’t offer to help you while you’re low and makes you feel guilty for needing to stop whatever you’re doing to attend to your diabetes. They reinforce the idea that what you’re going through “isn’t so bad.”
• Isolation from support: Your partner discourages you from connecting with others who understand your T1D, whether it’s your family, friends or fellow T1D community members. They may even mock or speak negatively about these groups. 
• Makes your diabetes an inconvenience: Your partner becomes resentful when plans change because of your T1D. They complain about alarms, lows, appointments and other diabetes-related challenges or needs. They make you feel guilty about it all.

If you find yourself in any of these situations, you may end up walking on eggshells around your diabetes or even hiding your struggles. But a healthy relationship should help you air it out in the open. You should feel genuinely supported and cared for and able to be your full self—yes, that includes T1D.

At the end of the day, this list is not exhaustive—you need to trust your gut about whether your relationship is toxic. 

“My gut was screaming at me to let go of the relationship I was in,” Greta says. “That’s when I knew I had to make a change.”

Seeing clearly outside of a toxic relationship

Carissa, another woman living with T1D who left a toxic relationship, shared the state of dysregulation her toxic relationship left her in and the impact it had on her T1D management.

“This toxic and very controlling relationship didn’t affect my diabetes until after I ended it,” she said. “Only after leaving did I realize just how toxic this relationship truly was, and the cognitive dissonance that came with leaving left my entire nervous system in a constant state of panic for almost a year.”

Positive Psychology explains that “cognitive dissonance occurs when there is a conflict between beliefs, attitudes or behaviors, leading to discomfort and a motivation to reduce the inconsistency.” During this period, Carissa reflected on how her toxic relationship left her drained of the emotional energy she needed to “care deeply about (her) blood sugar levels.” 

“I still took my insulin every day,” she said. “I was still following my usual habits, including intermittent fasting. Nothing on the outside had really changed, but I was putting significantly less careful thought into dosing insulin and being proactive about things that would spike or drop my blood sugar.”

Focusing more on T1D and less on a toxic partner

Greta says that leaving her toxic relationship had a similarly impactful effect on her T1D management.

“I didn’t realize how insecure my relationship was making me feel and what impact it had on my type 1 diabetes until I was out of it,” Greta explained. “Since being out of it, my insulin needs dropped, I started eating better, feeling more like me and have even lost a bunch of weight.”

During the relationship, Greta explains that she thought all of the stress she was feeling was normal. It took being on the other side of her stressful home life to see that the problem was inside the house.

“I made the difficult choice to leave a relationship I didn’t think was ‘bad enough’ for so long,” Greta shared. “When I was out of it, I realized all of the excuses I’d been making and the places I thought I was compromising were actually accommodations for my partner. I still don’t think they were the worst person, but now I see they weren’t the best person for me. Especially not for my life with type 1 diabetes.”

Much like living with T1D, we can tone down the intensity of situations (like 48 mg/dL readings) to make life a little more comfortable, but they usually boil over later. What was actually a life-or-death scenario reads as “just another Tuesday” in our heads, but if we carry those patterns throughout our lives, it can become dangerous.

“I wasn’t being abused and it was still toxic,” Greta said. “I think it’s important that we say that out loud as women.”

The impact of toxic relationships on T1D management

For some people with T1D, feelings of dysfunction or dysregulation that pair with a toxic relationship can influence blood sugar levels.

• Stress can raise blood sugar levels: VeryWell Health explains that when someone is stressed for a long time, the body releases more cortisol. Chronic stress is usually present within toxic relationships. Cortisol can reduce the amount of insulin the body makes. If insulin levels are off, blood sugar levels can rise. You may find your insulin needs go up in the middle of it all.
• Panic and anxiety can mimic low blood sugar symptoms: You might feel shaky, sweaty, dizzy or confused, which can make managing your blood sugar difficult. It may even lead to treating false lows, which can really mess with your blood sugar management. Panic and anxiety can also affect your decision-making. T1D requires you to be confident in your dosing decisions, so if you’re constantly second-guessing, it can add more to the mental load than is necessary.
• Fight or flight mode: If you’re always in survival mode because of your relationship, it can distract you from managing your T1D. You might forget about your diabetes needs or your blood sugar levels could get off track because you’re not paying enough attention. Also, stress or anxiety can happen, which can affect your blood sugar levels, as mentioned above.
• Depression: If your partner is not supportive, you might feel like a burden because of your T1D. This can leave you feeling isolated and lead to low self-esteem and confidence. You may even start to feel depressed, which can negatively affect your diabetes self-care.

How to get out of a toxic relationship

If your toxic relationship involves domestic violence, get help and call the National Domestic Violence Hotline at 1-800-799-7233. If your relationship is toxic but does not involve domestic violence, Carissa and Greta share their experiences to support others who may be going through the same things.

“Just leave,” Carissa says. “It’s f-cking terrifying. The first year is brutal. Don’t go back. Stay gone. Do all the work to keep understanding what you experienced, to know that it’s not you and focus on healing. The other side of it is freedom, and it’s worth the work to get there.”

Carissa enrolled in an in-depth coaching course designed to help women recover from cognitive dissonance within or after an abusive relationship.

“It changed everything for me after my first conversation with my coach, and my nervous system finally calmed,” Carissa says. “The daily crying completely stopped, and I feel like myself again. Even now that I’ve recovered from the initial trauma that I experienced during that first year after leaving him, my emotional patience for the nitty-gritty micromanagement tasks of T1D is significantly lower than it used to be.”

Carissa emphasizes that rallying around friends has been crucial to her healing experience. 

Support means everything to heal from a toxic relationship

“My best friend reminds me that I am still carrying a great deal of that trauma with me, and I know she’s right,” she says. “I’m in a very healthy relationship now with a loving man, but I still expect and anticipate him to start trying to control or criticize me. My nervous system is still under some of that stress, and it absolutely takes away from my patience for managing type 1 diabetes. My A1C and overall time-in-range have only improved slightly since that big shift in my nervous system.”

Greta never thought she’d have the courage to leave the situation she was in, but once she did, she was so glad. 

“I didn’t think I had it in me to leave,” Greta said. “But once I did, I never looked back. I never regretted it. And my life is much better for it. I still have grief. I’m still healing. I still have mental wounds, but I finally feel like me again. My T1D management, A1C and time-in-range have all improved since I made the choice.”

When it comes to relationships and T1D, your health always comes first. These women are a testament to that. If your partner isn’t supporting you in the ways you need with T1D, it can have a profound effect on your overall well-being. 

“You might feel like you have a lot to lose,” Greta says. “That’s valid and fair. But, at the end of the day, if you’ve lost yourself, that’s the worst thing. The worst thing you can do is turn your back on yourself. Leaving a toxic relationship is hard, but I promise you, it’s always worth it. Your body will thank you. T1D included.”

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