The three words, “You have diabetes”, usually have a profound effect on the individual, young or old, but especially the former. People tend to go through a myriad of emotions, ranging from guilt, confusion, fear, anger, self-pity and confusion to even, ultimately, relief. Some people tend to blame themselves for their poor food habits or erratic lifestyle and stress. Some people even feel that its life’s way of punishing them for some wrongdoing. Of course, one has the right to be on an emotional see-saw with the onset of diabetes, since it is a major life change like any other.

Initially, it often takes time to come to terms with diabetes, from several months to even one or two years. It is easier to be aware of one’s physical and emotional limits and be realistic about one’s inner feelings about diabetes. Take things slowly and do not push yourself or let others push you. When one is in denial, or simply does not want to acknowledge diabetes, sugars can run high due to non-compliance with diet, exercise and medication.

Those who have not been seriously ‘sick’ before, experience a sense of loss of previous good health. There is a sense of permanence and powerlessness. Furthermore, anxiety of family members and well-meaning friends and relatives, who are willing to give a lot of free advice (“take bitter gourd juice and fenugreek seeds first thing in the morning”, “Do not take medicines as it will damage the kidney”, “Try acupuncture”, “If you start insulin, it’s for a life time, so avoid it”) can add to a patient’s confusion

Knowledge and understanding about diabetes helps in coping with the daily challenges of managing diabetes and a sense of being in ‘control’.

Emotional adjustment to diabetes is a challenging process and is often likened to what a person experiences when they lose a loved one or are going through a crisis. It will help to understand what these four stages of grief are in concordance with diabetes:

Denial:

It is a way of coping with something when a person is not ready to face it. It is the opposite of acceptance. Hence, one tries to underplay their condition by telling themselves, “I’m on the borderline”, “Diabetes is not a big deal’, “The tests are wrong”, and so on.

Anger:

“Why me” comes to the fore here, along with, “I do not deserve this”, “I have not hurt anybody”, “Why bother, I’m going to get complications anyway”. There is a feeling of injustice, and of life being unfair.

Depression:

The individual feels overwhelmed by the many changes they have to make to their lifestyle. They feel that the joy has gone out of their lives. Fear of taking insulin sometime in the future sets in. Depression is usually characterised by insomnia, loss of appetite, mood instability, fatigue and loss of interest in usual activities. If symptoms persist, social support and therapy may be necessary.

Acceptance:

The final stage is acceptance, when the individual comes to terms with reality, accepts he has diabetes and learns to manage it. It is the opposite of denial, in other words.

Acceptance of diabetes is the first step in controlling it. It is more helpful to accept the things that one cannot change than trying to resist it, or keep complaining to aggravate the problem. Listed below are some coping strategies to help the newly-diagnosed to manage diabetes effectively:

Commitment:

Make a commitment to manage your diabetes. Education of diabetes can be empowering. Learn the basics of diabetes and follow the rules, dietary compliance and physical activity, apart from prescribed medication, should be incorporated into one’s daily routine.

Stress Management:

Stress may lead to lack of compliance and self-care, paving the way for high sugar. Simultaneously, stress hormones (in response to prolonged stress) prevent insulin from being released properly, thereby, aggravating the problem. Prioritising one’s work schedule, time management, and de-stressing through yoga, some sport or hobby helps in compartmentalising one’s life.

Lifestyle changes:

Make necessary changes to one’s lifestyle to achieve good results as far as diabetes is concerned. It may be a gradual process, but pays off in the long run. Adaptation is the key word here.

Positive acceptance:

Try and replace negative, self-defeating thoughts with more positive, proactive ones. Staying positive helps in avoiding resentment and depression and maintains good health and well-being. Acceptance does not mean ‘surrendering’ to diabetes or feeling resigned. It’s a matter of choice, which will help you take care of it.

Peter Asperella, in his fictional work, “Good Like This”, has neatly summed up the protagonist’s feelings about diabetes, “It’s not a horrible disease, it’s not something I have to conquer or destroy, it’s not an obstacle that I have to surpass. Maybe it’s just something I learn to live with happily, like a friend”.