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We received a great response from you to the "Diabetes and Your Emotions" posting that Peggy wrote last year. The strong emotions associated with diabetes are a normal part of living with a chronic disease. One of you reminded us not to forget about grief. Let's talk a little bit about grief.
Grief is a reaction to a major loss. People with a chronic disease such as diabetes experience a loss or potential loss of quality of life. The grieving process is natural. Everyone experiences it in their own way. There can be five stages of grief, but they don't necessarily occur in a specific order or manner. Not everyone experiences all of them:
When someone is newly diagnosed with a chronic disease, it's necessary to deal with grief. Any loss isn't easy and there will be periods of denial, sadness and anger. You may ask, why me? Anger can be directed towards your healthcare provider, family and friends. You may have feelings of guilt and ask yourself questions like, "Is it my fault, could I have done something different?" Are you fearful of complications? These concerns are all a part of the grieving process, which can come and go.
Over time, most of you will be able to accept the fact that your lives have been changed and find ways to adapt healthy coping skills. Accepting your diabetes has nothing to do with giving in to it. Accepting is when you stop trying to change the reality to make it fit your expectations, accept the change and begin taking care of it.
As humans, we're social creatures and need each other. Having another person for support, a support group, friend, or family member can help get you through the change and sorrow associated with grief.
If you're feeling alone in your grief or your diabetes in general, ask your healthcare team for information on diabetes support groups in your area.
Diabetes and grief; what are your experiences with it?
Sara J. Carlson, R.N., C.D.E.
Peggy Moreland, R.N., C.D.E.
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With a Masters in Social Work, I immediately recognized the stages of grief in myself when my doctor told me I am officially diabetic (type 2). Denial:I ate whatever I felt like for a couple weeks, like an alcoholic going on a binge before checking into rehab. I cried: why me? I was embarrassed and guilty: I had clearly been eating more than I burned, so this was my fault. 3 months later, As an emotional eater, I still have waves of frustration and grief most days, when I see foods I cannot have. It's not hypoglycemia causing the carb craving: it's desire! I have so little in my life that nurtures me, so treating myself to donuts and pizza and chips and ice cream was my one indulgence. I keep reading that exercise will help, but this dx is heaped on the grief that I used to be a dancer until an ill-advised surgery left me in chronic pain that is aggravated by almost any exercise. So yeah, I cope: I test a couple times a day, I try to have fun with creative salad add-ins, generally count carbs, and I'm in PT again to try to ease the tendonitis that prevents me from walking much. But when I walked past the muffin display in the cafeteria today, I felt genuinely sad. The grocery store is now SO depressing, and every meal is like an opportunity to screw up, not an event for pleasure at all. I'm annoyed that I had managed to almost completely give up artificial sweeteners, and now I am back to using those toxic add-ins to make some foods at least a little enjoyable (oatmeal, or home-made rhubarb sauce.) If I do indulge in pizza with friends, or birthday cake, I feel guilty and stupid. I really feel like if I don't have grand-kids by the time I'm 65 I'm going to say the heck with it and eat whatever I want, because death runs in my family anyway, so I might as well enjoy life while I have it.
I was diagnosed a month before my 10th birthday. It was then that my childhood ended and I had to mature. I spent the next year trying to get my head around things, getting used to all the pressure of having Type 1 diabetes. I didn't have time to grieving as a week after diagnosis my parents got a divorce, I needed to be there for my mum and support her. But when I got to the age of 14 I began getting massive breakdowns of tears every few months and tried to hide it away because I didn't want to upset my mum. Eventually I told my mum and my best friend and the both helped me through the stage. Sometimes all you need is support from the people you trust the most
SHERYLE THAT WROTE ON FEB 20 2010 ABOUT NOT HAVING ANYONE TO CALL AT ALL HOURS OF THE NIGHT ...I FEEL THE SAME WAY IM UP AND DOWN ALL HOUR OF THE DAY AND NIGHT.
Did people not know how to grieve before Kubler Ross came up with this little 5 step grief program in 1969? I learned the steps over and over again in nursing school...but it really offers little understanding to something as complex as grief. May I suggest that we drop it entirely? It did not help me to comfort patients in the ICU. The only thing that helps grief is compassion and empathy...There is no science to grieving..it lives in the heart.
I am so tired of the little grief package...denial, bargaining depression etc. Human beings are far more complex than this little mantra. I have no denial...no bargaining..I accept the diagnosis that has so affected our entire family...what I have is sorrow for the loss of my son's childhood. Sorrow. It will ebb and flow, but I will carry that sorrow forever. I accept the sorrow, but that will not make it go away.
I am angry. Why me?, I ask.
Apparently I am too sweet!!-- and I am. I let people run all over me. But no more. That behavior made me lazy, and heavy weight-wise, never telling people to back off, to stop bullying me...eating to fill the void and to stuff-down the resentment.
It can be overwhelming to get this diagnosis-- especially if you have had other things to grieve in your life.
I went to a research hospital/clinic in Minneapolis for my education and nutrition advice-- they were after me to do bariatric surgery to control the diabetes which was pretty under control then quite easily-- I was only in their criteria weight range for that surgery by 1 pound. One!
I no longer trust anyone associated with diabetes care because of that. It is big business and we need to be alert and advocating for ourselves. Question what they tell you...
We are viewed as people who suddenly need to be treated like small children when we get this diagnosis--being called to see if we would (oh please, they ask) be in studies, being monitored, being talked down to.
It is a pain. I started exercising today. I will get healthier. I will not be a guinea pig for researchers.
I was diagnosed with diabetes at the age of 28. I am now 35 and I've experienced DKA (with a stint in the hospital for 5 days) plus out of control A1C results. I am finally ready to except the fact that I have diabetes and try to brimg my levels down to between 85-125. But I am still very angry that I have this elephant in my life. And sometimes I feel like I look like that elephant because since I've been watching my levels and taking ALL my insulin I've gained weight. It's very frustrating. So, yes I grieve over the life I had before I turned 28. It was what I thought a healthy life. A happy life. A life that was carefree. I miss it.
This is my story about the grief I felt as a mother when Type 1 diabetes hit my family: http://promotinghealthandpatienteducation.blogspot.com/2008/12/type-1-diabetes-and-grief.html
Nice to see your article acknowledging the grief associated with diagnosis of a chronic condition.
It is not unusual to have high blood sugars when you are on steroids. The problem with high blood sugars is that you can become dehydrated very quickly. Your diabetes medications may need to be adjusted. Insulin may be necessary when you are on steroids to keep your blood sugars down. We recommend that you see an endocrinologist that specializes in diabetes in your area.
I have type two diabetes, I have excepted the fact that I have it. My problem is that I also have severe asthma, so in the cold months, I have to be on steriods to help my lungs. My blood sugars stay around 400 they were 484 earlier today. Call the doctor to let them know. ADont worry about it you are only on the steriod for 5 days that blood sugars will go back to normal. This can not be health for me at all, with the up and down of my sugars. I am so scarred and feel all alone. I have a wonderful husband and daughter who are there for me, but they are as worried as I am. My husband is getting so mad at the hospital here, when we call in the middle of the night my sugars have just peaked to almost 500, thier answer is if you are not having any syptoms dont worry about it. So ask what to look for they said it varies you will know. WHAT WHEN I AM LAYING ON THE FLOOR AND MY FAMILY IS AT WORK AND I CANT GET HELP.
This sneaky disease, creeps up on you and bam! Your depressed, angry, and in denial. I don't feel any mentally different but it's pretty obvious to my wife, who seems to get the blunt of my frustration. I think it's her things she says and how she is about things, she tells me she's always been this way. So with the hope, of new discovery's in medical technology's and the great physician, vision can be restored and the bam can be kicked to the curb.
Two weeks before Christmas the lab tests from my physical showed a fasting glucose of 213 mg/dl.... I knew I was in trouble even before going back to the doctor. I was sad and angry because I knew I was borderline many years earlier (when I was 39, I am 46 now). I had even years before dropped 70lbs and let all that progress escape, returning once again to my BMI of 40. My A1c tested at 8.5% -- the diagnosis was abundantly clear. Now the Doc said I would have to test daily and probably take meds for the rest of my life. That brought tears and anguish. The good news: A supportive family and colleague at work brought me renewed determination. I have been testing my blood levels 3 times a day, eating less and avoiding high glycemic carbs, and walking 3 miles a day. Result -- returned to the Doc after 2 months bringing my graphs of my glucose levels and now my A1c tested at 6.1% and I had lost 12 lbs. Now for the next 3 months - NO MEDS and I am feeling great and committed to this new and enduring lifestyle. As much as the grief of diagnosis brought me down, the joy of accomplishment shared with my family and friends caused me to dance all day long.
I'm so very glad to see this information posted on your site. I believe that the depression over having health issues that were compounded by Type 1 diabetes is what killed my late husband. He fell into despair after losing three jobs in a row and being diagnosed with kidney failure and aortic stenosis. He insisted that he wanted no surgeries and was terrified with the prospect of dialysis. He had done well before that but his diabetes was very brittle and he always had trouble with wild blood sugar fluctuations. I tried to get help for him when I noticed a change in his eating, sleeping, and socializing habits, but I don't think his endocronologist or kidney specialist believed me, since my husband always joked around with them during office visits. Doctors need to meet with spouses/caregivers of chronically ill patients regularly and, if needed, refer all of their chronically ill patients and their care givers/spouses for counseling --especially as a chronic illness progresses. Keep telling people about these issues. You are doing a great service - saving lives.
I was 24, had just been married to my high school sweetheart; and was embarked on a life long dream of being a pilot in the USAF when I was diagnosed with type 1 diabetes. My efforts to remain in the service, in some capacity, were for naught. After four months I was discharged and settled into three months of "poor me" depression.
Somehow, I snapped out of it, and began trying to figure out what I could do for the rest of my life. Looking for a job was another life struggling process I had no idea of handling. Most interviews, after finding out that I was diabetic, would say they could not hire me because of my condition.
I finally was hired by Macy's of California with little problem. After a few years I applied for and won a position in a local government, which did not have any problems with my "condition."
While working and going to night school, I got advanced degrees; and finally decided I wanted to go to law school. I graduated, passed the California bar and continued with my career in local government.
My wife and I raised two great children. Our daughter became a type one diabetic at the age of 11. She accepted her condition, as well as, could be accepted. She married a type 1 diabetic; and they now have two children of their own. They follow their children with DNA tests available through a UCLA program.
I watch my condition fastidiously and maintain an A1C averaging 6.5. My diagnosing doc said I would live long if i took care of myself. I am 43
I found this useful and wish some discussion like this were readily available for people who are diagnosed with a chronic, serious mental illness.
i had breathing problem after allergic reaction to moving the lawn in my 40's. was diagnosed asthma. while on other asthma meds i was given some tablets. three months later diagnosed with diabetes. i was shocked.
before the asthma treatment i had perfect health.
in the very first session doctor gave me full information from hypo to hyper and eyes, kidney, heart attack and amputation.
it was too much for me. i had some negative thoughts. i wasnt ready for all this. i thought if doctors are killing me with their mis diagnoses and prescribing life threatening medication, its better to kill my self as there is no cure for diabetees or asthma.
it can be controlled and is like a slow death process. starting from one med to another and then die like a vegi / monkey state.
i thought its better to end my life rather be on variety of meds and have several other diseases and the after affect of the cocktail of meds.
no one referred me for 2-3 years to any other allied health professionals e.g. dietician, hydro, allternative therapy or counselling etc
sudden information of such illnesses is a major shock and life threatening as well.
some of the sites on internet gradually helped me out according to my pace of time, of this vicious cycle of loosing interest in my life.
moreover no doctor takes the responibilty for mis diagnoses and prescribing wrong / strong meds.
now i am 50, not going any where when some one is moving the lawn. and i am on diet plan.
I was devastated when I was told I had Diabetes 2. I had watched my brother on dialysis and the beds empty and fill and empty and fill. His body finally quit and the dialysis was not helping anymore. He passed shortly after. He had been on dialysis for 3 years. He also was a partier in his early days and abused his body terribly. So after I was diagnosed i cried, was very angry and then i had to accept my new life. I started to read and bought diabetic cookbooks. I changed what I was eating and bought a glider to exercise. I have my bad days but i met a woman who had been doing dialysis for 30 years, others 15 years. I am just doing diet so far and testing my sugars. If they can live well for years I can too. So be brave my friends and live life to it's fullest.
I'm 65, have had type 2 for 30 years, had middle toe removed left foot, big toe removed right foot, then all toes removed right foot last Oct. Had 6 by-passes 7 years ago, chronic pain for 12 years due to degenerative arthritis. 2009 spent 14 days in hospital, had 55 apointments at Luther-midelfort Clinic and take over 7,000 perscription pills a year. Besides that I'm 6'-10" and weigh 280#. Depressed, NO! I'm always at the Clinic and know many emplyess there, they can't believe my attitude. The key is "Acceptance!". Don't get to high when feeling good, or to down when feeling bad. BELIEVE ME it is easier said than done. I still fish, play with my beautiful 4 year old grandson and enjoy myself. Oh, may not be depressed but from time to time get pissed off about everything, seems to help also;-> You can do it!
I was diagnosed with type 2 diabetes about five months ago and I read your article with great interest. I am 67 years old and have suffered with clinical depression and anxiety problems. The diabetes diagnosis created within me no grief and I know about denial, if anything my other problems seemed to decline significantly when I started taking the medications prescribed me for the diabetes. At this point I wonder how long the diabetes went undiagnosed, and, possibly contributed to the depression and anxiety. In fact I feel much better now than I have in many years, It is fascinating to have come across the article about grief and diabetes. For those who do suffer the grief, I commend their struggle, for with that struggle eventually passes and , at that point, they can carry on with the management of their diabetes. Thank you. Lloyd
Does anyone know if overall life expextancy is reduced by Diabetes?
When our 15-month-old daughter was diagnosed with type 1 diabetes 21 years ago, I experienced feelings of grief and guilt. I kept trying to figure out what I had done during my pregnancy that caused her to have diabetes. My husband, on the other hand, accepted the condition and got busy learning what needed to be done.
We never let our daughter feel that she was different or sickly, but we did begin organizing our life a little better and planning in advance. We accepted the limitations and matured into better parents.
Several months ago, I was diagnosed with breast cancer. I went into denial and anger mode, and I had a tough time accepting my body's betrayal. After a lumpectomy, chemotherapy, radiation and continuing herceptin treatment, I am being more practical about my medical situation. It is not easy, but I am beginning to fully understand the saying that "what doesn't kill you makes you stronger".
No one's body is perfect, and most of us will face a challenge. Our daughter's challenge occurred before she could compare life before diabetes. Mine occurred after 54 years of great health. Either way, we both respect our health in general, and don't give in to self pity.
However, I believe one should have the time to mourn what I call "the body's betrayal' and then accept the facts and move into being a positive role model for the next person who will face a similar challenge.
I've been daignosed with Diabetes dec'08. iam still coping with anger -sadness & depression issues related to it. How can start accepting the life style change.
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