Sunny dispositions ease life with diabetes

"We believe that what's under the surface—what people are thinking and feeling, and how they're reacting to diabetes and making meaning of it—is what is driving poor diabetes self-management," says Heather Stuckey. (Credit: Greg Peverill-Conti/Flickr)

Coping with the psychosocial challenges of diabetes can be tough, but a positive outlook about the disease and support from family, friends, and healthcare professionals can help.

The Second Diabetes Attitudes, Wishes and Needs (DAWN2) study is the largest analysis yet undertaken of personal accounts of people living with diabetes. The original DAWN study in 2001 found that 41 percent of adults with diabetes have poor psychosocial well-being.

In the follow-up study, almost half—46 percent—of people with diabetes had negative emotional, psychological, and social experiences related to their illness.


Two major negative themes emerged. People with diabetes reported feeling anxiety, fear, worry, depression, and hopelessness about their condition, and they experienced discrimination at work and misunderstanding from the public.

One in five study participants reported workplace discrimination, including losing their job due to their illness.

The researchers administered online, telephone, and in-person questionnaires to 8,596 people with diabetes living in 17 countries, including the United States and Canada. Patients with type 1 diabetes and patients with type 2 diabetes were included. The results appear in the latest edition of Diabetes Care.

As part of the follow-up study, researchers asked people with diabetes about their successes with the condition, as well as their challenges.

“We found that although these negative experiences with diabetes exist, people also held on to the positives,” says Heather Stuckey, assistant professor of medicine at Penn State and lead qualitative investigator for DAWN2.

“Some said diabetes made their lives a little richer because they ate healthier foods, or they were able to connect with their family more to overcome challenges. It gave them a better appreciation of what they have.”

A vicious cycle

A recent update to the National Health and Nutrition Examination Survey found that a large percentage of people with diabetes have poorly controlled glucose levels.

Researchers believe uncontrolled diabetes cannot be explained by lack of diabetes knowledge alone, so the DAWN studies consider psychosocial factors that contribute.

“We believe that what’s under the surface—what people are thinking and feeling, and how they’re reacting to diabetes and making meaning of it—is what is driving poor diabetes self-management,” Stuckey says.

Several messages for people with diabetes and those caring for them emerged from the study.

Some people with diabetes are reluctant to share their challenges and needs because they do not want to be perceived as a burden to family members. This creates a vicious cycle because family members do not always know how to help, so the person with diabetes can feel more isolated and disconnected.

“We would like to encourage patients to be able to share their thoughts and experiences about having diabetes with family members and other trusted individuals,” Stuckey says. “We believe that will relieve some of the stress that people experience and will improve living with diabetes.”

While dealing with diabetes can be a struggle, a positive outlook really does help. Many of the study participants reported a silver lining of their diagnosis, such as weight loss or a better understanding of others’ illnesses. Looking on the bright side kept them motivated to get through challenging times.

“If we can look for the kernels of positivity within the negativity, that’s where that sense of resilience seems to be coming from,” Stuckey says.

How families can help

As people with diabetes start to share, family members often do not know how to help.

“Our advice is to ask them outright: ‘Is there anything I can do for you about your diabetes care today, or over the next week?'” Stuckey says.

Family and friends can also educate themselves about the disease by visiting the websites of the American Diabetes Association and the International Diabetes Federation, and by attending doctor’s office visits.

“Although there are negative psychosocial aspects of having diabetes, we found that people are resilient and find ways to adapt,” Stuckey says. “If people with diabetes can be more open and share their experiences—and if we can listen to them—that can increase understanding and self-management.”

Additional researchers contributed from Novo Nordisk A/S in Copenhagen, Denmark; Avicenne Hospital in Bobigny, France; University of Alberta; University of Perugia; Dalhousie University in Halifax, Canada; University of Antwerp; Steno Diabetes Center in Gentofte, Denmark; and Loyola University Maryland.

Novo Nordisk, a manufacturer of diabetes care products, funded this study.

Source: Penn State