Presented by: Eliot LeBow LCSW, CDE

DIABETES DISTRESS AND EMOTIONAL WELLBEING

November 10, 2016

Disclosure: Eliot LeBow LCSW, CDE

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With respect to the following presentation, there has been no relevant (direct or indirect) financial

relationship between the party listed above (and/or spouse/partner) and any for-profit company in the past 24

months which could be considered a conflict of interest.

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MR. LEBOW IS A DIABETES-FOCUSED PSYCHOTHERAPIST WITH A PRIVATE PRACTICE IN NEW YORK CITY. HE PROVIDES TALK THERAPY, COUNSELING, DIABETES EDUCATION AND CONSULTATIONS IN HIS OFFICE AND ONLINE TO PEOPLE LIVING WITH DIABETES WORLDWIDE. MR. LEBOW WAS DIAGNOSED WITH DIABETES IN SEPTEMBER OF 1977 AND HE HAS MANAGED IT FOR MORE THAN 38 YEARS.

Eliot LeBow LCSW, CDE

Diabetes Distress

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Diabetes Distress is a combination of emotional burdens and

worries that are related to the experience of living with and managing diabetes. Diabetes Distress is sometimes misdiagnosed as depression

and has links to problematic glycemic control and difficulties with self-care behaviors. It causes frustration with diabetes management, and patients

experience fears around potential complications, erratic blood glucose levels, an increase in hyper and hypoglycemic episodes.

Internal Sources

Underlying causes of Diabetes Distress for Type 1 Diabetes Feeling powerless around controlling diabetes Excessive worries about long-term complications Frustration with management tasks Fear that food constraints are controlling their life Poor confidence with regards to quickly identifying

hypoglycemia Fear of embarrassment and potential risk of life

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Social Sources

Underlying causes for Type 1 Diabetes Negative Social Perceptions Fear about being treated differently Less attractive to employers

Family and Friends Over or under-involved Treat as overly fragile

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Physical Sources

Underlying causes for Type 1 Diabetes Insufficient help, support or understanding from

health-care team

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Type 2 Sources

Four areas of distress Emotional/Internal Related Fear, Anger, or Powerless

Physician/Health-Care Related Regimen Related Medication & Diabetes Management

Interpersonal Related Family & Friends

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Mini-Traumas

Micro-traumas in your patients’ lives can be anything that is

related to managing diabetes that prevents or interrupts what they are doing at that moment. Essentially, anything deviating your patient from their plan.

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Diabetes Fact

It’s never as simple as 1 + 1 = 2

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Symptoms

Behavior and emotional changes to look for: Victim Role “Poor Me.” Struggling with everyday tasks and diabetes management Poor Blood Glucose Management Feelings of frustration and exhaustion

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Symptoms

Behavior and emotional changes to look for: Blood glucose testing has reduced or stopped altogether Isolation with feelings of depression Missing Medical Appointments Problems with Healthcare system

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Prevention

Things your patients can do to avoid or reduce distress: 1. Be Patient Swim with the current

2. Avoid Impulsivity 3. Flexibility Stop and change direction

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Prevention

4. Planning Ahead 5. Acceptance… Situation Medical System Health Insurance Personal

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Prevention

6. Talking To Others Non-bias people Avoid Isolation

7. “Here & Now.” 8. Relaxation Activities 9. Cognitive Behavioral Therapy

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Diabetes Self-Management

It’s Personal

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Helpful Tips

Judgment Resistance Labeling Hemoglobin A1c Encourage Motivate

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Forgiveness

Allow Your Patients To Be Human

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In-general

Enjoying life is critical to reducing diabetes distress.

However, if you believe your patient is suffering from diabetes

distress, please refer them to Psychotherapist whose specialty is diabetes or chronic illness.

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Here’s Where You Can Find Us CONTACT

ELIOT LEBOW LCSW, CDE

e: eliot.lebow@gmail.com o: 917-272-4829 323 West 96th Street, New York City Website: www.diabetictalks.com Facebook: www.thediabeticdiary.com

Diabetes-Focused Psychotherapist

Sessions available in the Manhattan office or via Skype

References:

Fisher L, Polonsky WH, Hessler DM, Mullan J. When Is Diabetes Distress Clinically Meaningful?. Diabetes Care 2012 Feb; 35(2): 259-264. Gonzalez JS, Polonsky WH, Fisher L. Depression in Diabetes: Have We Been

Missing Something Important? Diabetes Care 2011 Jan; 34(1): 236-239. Pallayova M, Taheri S. Targeting Diabetes Distress: The Missing Piece of the

Successful Type 1 Diabetes Management Puzzle. Diabetes Spectrum 2014 May; 27(2): 143-149. Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan JT, Jackson RA.

Assessing psychosocial stress in diabetes. Diabetes Care. 2005;28:626–631. Polonsky WH, Fisher L, Hessler DM, Masharani M, Blumer I, Peters AL,

Strycker AL, Bowyer V. Understanding The Sources Of Diabetes Distress In Adults With Type 1 Diabetes. J Diabetes Complications. 2015 May-Jun; 29(4): 572–577.

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