Be Mindful About Diabetes - Focus on Mental Health

June is Brain Health Awareness month and a great time to start focusing on helping your brain develop better habits. You can keep your sharpness, acuity and enhance your learning abilities. Most people who have diabetes are aware of common potential complications such as heart disease, high blood pressure, nerve problems, foot issues and eye complications. However, they are unaware of the “mind and body connection”.

Getting your mind in shape will help better control your diabetes. Learn more about your mental health, how to improve it and how it relates to your diabetes.

Diabetes Overview

Diabetes is a metabolic disorder that is caused by a lack of insulin or insensitivity to insulin. Often pharmaceuticals and natural health products are recommended by doctors to help improve blood sugar control and reduce the risk of diabetes-related diseases such as nerve damage, cardiovascular problems, kidney failure and blindness. Sometimes the mental health implications of living with diabetes are undermined and often overlooked. A complete approach to your overall health helps people with diabetes maintain a more balanced body and mind connection.

Diabetes & Your Brain

Uncontrolled diabetes can cause damage to your blood vessels especially the tiny ones in your brain. Your brain is sensitive to glucose since it is used for energy or fuel. The brain only weighs 3 pounds, but it “is the most glucose energy demanding organ” in the entire body. The lows (hypoglycemia) and the highs (hyperglycemia) of diabetes and the constant variations, can have a huge impact on brain health. Type 2 diabetes often goes undiagnosed which exposes these small blood vessels to excess glucose. When this happens repeatedly, there are hormonal shifts, weight changes (mostly weight gain), problems with your memory and ability to learn.

There is new evidence from a study done on over 20,000 participants in England that showed type 2 diabetes is connected to brain aging and cognitive decline. The participants included in the study were only those who had type 2 diabetes (not type 1 diabetes). The participants were analyzed using specific measures including “abstract reasoning, executive function, processing speed, reaction time and numeric memory data”. Although age was a factor which showed decline in mental abilities, those who also had type 2 diabetes had a “significant decrease in cognitive function” beyond being related to just an aging brain. Also, those who had type 2 diabetes for the longest period of time, had the most cognitive problems and learning changes.

At this point, the researchers concluded that “type 2 diabetes and its progression may accelerate pathways associated with typical brain aging”. The thought is glucose cannot enter the brain since it is unavailable and damage occurs. More research and studies are needed but the best answer at this time would be to have an early diagnosis of diabetes with complete diabetes treatment. This includes proper diet, exercise and diabetes medications when needed.

Diabetes & Behavior

Optimistic and pessimistic traits are not strongly inherited characteristics but more of a learned behavior. They are based on “environmental experiences and past life experiences”. Optimism is being hopeful and positive, and pessimism is having negative attitudes or displaying learned helplessness. Challenging your negative thoughts and talk and replacing them with positive ones helps you learn to be more optimistic. Your emotional well-being is as important to diabetes control as your physical well-being. Being stressed and aggravated makes your blood sugars rise. Do you know how you react to stress or a negative event? Do you look at the glass as half full or half empty? Sometimes sadness and anger are an appropriate response, depending on the situation, but do you dwell on things and stay in the negative, way too long? Learning to manage your emotions and feelings can help you control your blood sugars.

Diabetes & Medication

Many people take oral supplements thinking they will supply additional brain abilities and brain health. Do they really make a difference? Over $7.2 billion was spent in 2020 on oral brain health supplements alone. Research done by The Global Council on Brain Health (GCBH) emphasizes, “they did not find sufficient evidence that taking any of these supplements would benefit brain abilities”. According to most of the current research, “unless you are deficient in a nutrient, you should not take supplements for brain health. For example, some people may be lacking in vitamin B12, or folate and they would actually benefit from adding it as a supplement.

Taking added supplements for your brain may even cause negative interactions with prescription medications. Also, all supplements are not created equal. There can be dramatic differences in the ingredients even when listed on the label. They may contain contaminants or impurities. Stop wasting money on oral brain supplements and instead, work on the techniques listed below. If you do choose to take a brain health supplement, talk to your physician or pharmacist to make sure there are no negative interactions. Check and make sure it is verified by either: USP (United States Pharmacopeia), NSF International or ConsumerLab.com. These organizations expect and demand more consistency in the products that they do endorse.

Diabetes & Emotions

Experiencing different emotions are normal. You may go from you being centered and thinking clearly to being sad, frustrated, anxious, annoyed, depressed and unfocused. Having unpleasant emotions is acceptable at times but remaining there for extended periods of time can be detrimental to your diabetes control, overall health and well-being. Displaying lack of resilience means feeling victimized, developing eating disorders, establishing alcohol or drug dependency, all possibly used as coping mechanisms. Here is where resilience comes in.

Resilience is defined as, “The ability to recover from life’s difficult events”. It is when you come back from life’s hard times, unexpected bad things and negative events. Resilience comes from within you and from the people who help support you. Developing resilience can be an uphill battle for many of us. Those with mental resilience have an “emotional toughness” by working through it. It can save you from being overwhelmed and forgetting to take care of yourself and your diabetes. Learning and practicing resilience are not easy, but well worth your time and effort.

While having diabetes type 2 may increase the likelihood of mental health issues, there are various ways to overcome them and develop improved psychological health.

Things to enhance your mental health well-being and help diabetes control

Yoga can calm the nervous system and build better body awareness. Breathing and stretching exercises help boost muscle strength and flexibility while minimizing stress, anxiety, and depression. It can relieve chronic pain, improve sleep patterns, and promote improved cardiovascular function. Yoga breathing can slow your heart rate and help with mental focus and acuity. You can practice yoga on your own with just a mat and a few simple poses. You can find a group class for more comradery. Yoga has been around for centuries helping our minds develop and find focus.
Nutrient dense diets – people with healthy brains eat nutrient dense diets and practice healthy lifestyles. When populations are studied around the world, those with the best memories and brain power consume certain and specific nutrients. The Mediterranean and Mind diets keep appearing in these populations. The nutrient dense foods are high in Omega 3 fatty acids, Vitamin B, Vitamin D, Vitamin E, magnesium, polyphenols, fiber, and probiotics. Staying hydrated with clean, fresh water is another common factor seen in populations with healthy minds.
Meditation is a practice to help people stay in the present, keep a positive attitude, relieve pain, and develop better sleeping habits. Wasting energy thinking about past events or future experiences is negative. You can only control the now. Meditation helps keep you in the moment. Meditation can free you from negative thoughts if you allow it. It can also reduce feelings of depression and anxiety. There are free meditation Apps or YouTube videos to assist you in the practice of meditation. There are community centers that offer free meditation classes.
Massage therapy “is the manual manipulation of muscles and other soft tissues in the body including muscles, connective tissues, ligaments and tendons”. Massages can improve quality of sleep, increase your happiness, and calm your mind. Massage can help reduce irritability and anxiety, improve the use of insulin, and increase blood circulation to essential areas of the body. Massage can raise the feel-good hormones such as serotonin and dopamine and lower cortisol, the stress hormone. There are multiple types of massage available including Swedish, Hot stone, aromatherapy, Thai, and many others; all offer the beneficial effects. There are massage memberships available in certain chain stores or you can get a massage therapist to come to your home. Some hospitals offer massages in their Physical and Occupational health centers. You can teach your partner or spouse to give you a massage to help relax you.
Personal relationships are important for mental health strength and focus. It can be from family, friends, colleagues, neighbors, people from church, mosque or synagogue, associates or classmates or mental health professionals. Whoever bonds with you and understands your needs during a difficult and challenging time is an asset for your mental health and well-being. You can even reach beyond your social support system, deeper into the community. Mental health care workers, case managers, psychologists, psychiatrists and social workers are generally available either through your health insurance or for a cash payment on a sliding scale fee. You may rely on them short term-during a crisis or establish a long-term relationship. Joining a support group focusing on a similar problem can be a strong asset when dealing with your mental health. Utilize all resources you can find. It is OK to ask for help.
Self-confidence is an important quality when dealing with mental health and resilience. Believing in yourself and knowing you are capable of handling the situation is critical for a strong sense of self. You may have setbacks, but if you can push forward and believe in yourself, your mental health will flourish. There is nothing more important than relying on and trusting “in you” to get you through any and every difficult situation.
Having a purpose, a meaning or a specific motivation can build resilience and mental coping abilities. Join a club or group. Find a part-time job. Volunteer. Take a class. Read to children. Find a way to challenge yourself mentally.
Learn to be a better listener than being the one doing all the talking. Listening helps you become more patient with others and yourself. Listening is a wonderful skill that can be developed. You learn to really hear the conversation instead of anticipating what you want to say next. You will remember what was discussed.
Be kind to others. When you are overwhelmed or unhappy you tend to take it out on those around you, especially those you love. Work hard on trying to be nice especially at the most difficult time. Be kind to others, but especially to yourself. Show yourself patience, courage, and strength. Do not spend time belittling yourself. Do not dwell on what you did wrong or what you do not know. Remember that you are human, and everyone makes mistakes. No one knows everything. Show forgiveness to others and yourself. This will build your own resilience.
Self-control tends to diminish when you are under pressure, difficult times or even during a crisis. Your ability to cope can crumble quickly. Being flexible, rolling with the punches and being able to accept the circumstances, even when they may not be the best outcome, will help you cope and move on. Show your willpower and strength. Self-talk, positive thoughts and phrases should be used. Journaling your feelings is particularly important. Writing and rereading your own words and thoughts can be empowering. Understand you have probably lived through difficult times before and try to pull from those experiences again. Reading affirmations and positive words by others who have experienced hard times is also helpful. Keep positive phrases in your head and let them become your “mantra” or word.
Be hopeful. Know that you may have some setbacks and decide to do nothing. Understand that being still is normal as long as it does not persist for a long period of time. Seeing the positive in each situation makes you hopeful again and can get you back on track.
Find gratitude in the day and in the moment or the situation. Gratitude is different than hope. Be thankful and appreciate all the little things in life. The smell of fresh flowers or grass being cut. The sun in the sky or seeing a rainbow. Drinking a good cup of coffee in the morning. Sharing a meal with a loved one or friend. Even your ability to take a deep breath. All these things can make you see the beautiful wonder in life and focus away from your negative thoughts.
Be rational and think things through. When you instantly react to a crisis or bad situation, you have not examined the true possibilities of dealing with the situation. You get off track and do not think, you react. Say you misplace your car keys, and you are in a rush. Instead of “melting down”, take a deep breath and retrace your steps. Think, and act, slowly and rationally, instead of just reacting. Thinking, contemplating, and coming up with a plan will go much further than not coping or “losing it”.
Exercise is an essential part of any effective diabetes self-management and mental health plan. Exercise for at least 30 minutes, 5 days a week. You can break up the 30 minutes into smaller increments without losing the benefits. You can do it alone or make it a social activity. Make exercise fun so you look forward to it rather than dread it. There are simple ways to include it into your life. Regular exercise can boost the feel-good endorphins in your body and help relieve stress. It also helps with improved blood sugar control. Try walking, swimming, dancing even gardening or cleaning. Get off the couch.
Wholesome nutrition. Besides a nutrient dense diet discussed above, -eat a well-balanced diet that includes fresh or frozen fruit, vegetables, lean meats and fish, low-fat dairy, and whole grains. Use small portion sizes. Have three meals; you may need at least two snacks daily to avoid blood sugar fluctuations. This depends on your present weight, blood sugars and diabetes medications. Talk to your dietitian, nurse, or physician about snack specifics. Never skip meals. Do research on-line for creative and easy diabetes-friendly recipes. Take a cooking course. Try new fruits and vegetables when they are in season to add variety and affordability. Eat meals with friends or family for social interaction. Sit while you are eating. Do not read, talk on the phone, or watch TV. Do not eat on the run. Savor, smell and taste the food instead of gobbling it down.
Take time to be social and have fun. Often, your diabetes self-management takes up a large part of your day. Learn to be and stay happy. Unwind with friends, play a game that can help boost your memory, such as Sudoku. Rediscover a favorite hobby or pastime such as reading, jogging, or doing crafts. Do a crossword puzzle. Play word games. Learn a card game. Take up a new language or musical instrument. Join a choir. Join a club where you are expected on a weekly or monthly basis. This may encourage you to continue to pursue hobbies and interests you enjoy. Find something you are committed to and look forward to.
If feelings of stress, depression, anxiety or being overwhelmed are unsurmountable or if you are unable to cope, consider a discussion this with your physician. Sometimes medication can be the answer but trying lifestyle changes first are important habits for your brain and its health.

You may be taking incredible care of your body with diabetes, but make sure to consider your mind, too. Positive mental habits can help you maintain better blood sugar control and reduce the symptoms of mental health issues. Learning resilience and depending on yourself can be very useful tool. Know you do not have to succeed only on your own, but you can if you have to!