As with other chronic diseases, a diabetes diagnosis means that your health is impaired, and your future health is threatened by the medium- and long-term complications associated with the disease. This “sword of Damocles” hanging over your head can be very stressful.

Stress can impact your diabetes control due to the effect of stress hormones on blood glucose (sugar) levels or even to poor stress-management strategies or behaviours.

A responsibility

Furthermore, you are directly responsible for the complicated, demanding and chronic treatment of your diabetes, which can require major changes to your daily habits.

On one hand, you have the power to change the course of your disease; on the other, you are burdened with this enormous responsibility.

A blow to your self-esteem

Diabetes can also weaken your self-esteem, which can be compounded by the discrimination you might face at work, when you apply for insurance or a driver’s license.

The adjustement process

The process of adjusting to the stress of diabetes happens in 5 stages, similar to the stages of mourning.

The better you understands your diabetes and its treatment, the less fearful and accepting you will be, and the more involved in your treatment and diabetes control.

1. Denial

Denial, refusing to even acknowledge the existence of the diabetes, its chronic nature or the necessity of treatment.

“No, not me!” “There must be some mistake.” “This is just a temporary rise in my blood sugar; I will get better.”

2. Resistance and rebellion

Awareness of the real, serious and chronic nature of diabetes raises anxiety levels and causes anger and rebellion.

Feeling powerless and pessimistic about being able to properly adjust to the diabetes and its requirements

“Why me?” “It’s not fair; everyone else is in such good health!”

Hidden beneath this anger is often sadness, fear, impotence and feelings of isolation. Don’t hesitate to express your feelings to a health care professional you trust, or seek support from family, friends or other people with diabetes.

3. Bargaining

Partial acceptance of the treatment but bargaining about which treatment elements to accept.

“OK to injections or tablets, but no to exercise… I still have to have a life! ”

4. Self-assessment

High anxiety levels: self-assessment and hyper vigilance.

A perfectionist approach to treatment. Intensely anxious about occasional deviations from target blood glucose (sugar) values, limiting social activities to minimize such deviations, eventual depression and exhaustion.

“My diabetes control has to be perfect.”

Moderate level of anxiety: self-assessment and receptiveness.

A positive attitude, accepts useful information to better understand and control the diabetes.

“I will see what I can do to better control and live with my diabetes.”

5. Active acceptance

Awareness that you can cope with your diabetes by taking an active part in your treatment while feeling well psychologically and having a satisfactory social life.

“Diabetes isn’t a problem anymore because I can control it.” “I am living well, with diabetes.”

An individualized path

The work of acceptance and adjustment does not necessarily happen in this specific chronological order. Also, the duration of each stage depends on a number of factors specific to you and your environment. Some people are able to work through to acceptance within a year of their diagnosis, while others may deny or resist their diabetic condition for many years.

Furthermore, the work of acceptance is never done. Some days are harder than others and new challenges (switching from oral medication to insulin injections, diagnosis of a complication, stressful situations entirely unrelated to the diabetes, etc.) may arise, provoking reactions from earlier stages and thus reactivating the process.

One step toward change

Accepting your condition is already a step in the right direction, even before you take any action. Learn more about the stages of change and the tricks you can use to change your lifestyle habits to live better with diabetes.

Resources for you


Other resources

Research and writing : Diabetes Québec’s team of health professionals

Adapted from : Gosselin, Marjolaine, Psychologist, (Spring 2000) “Le stress au détour du chemin,” Plein Soleil, Diabetes Québec, p.25.

Scientific review : Dr. Alain Janelle, Psychologist

July 2018

© Diabète Québec