For many diabetes patients, the emotional burden of managing the disease can often outweigh the physical symptoms, creating a vicious cycle that can lead to long-term health risks if left unaddressed, warns a UAE-based internal and lifestyle medicine specialist.
Globally, an estimated 537 million people are living with diabetes— that’s approximately one in every 10 adults whose wellbeing is impacted by the chronic condition.
Dr. Aarti Javeri-Mehta, an Internal Medicine Specialist and Board-Certified Lifestyle Medicine Physician at Sustain Health in the UAE, stresses that the rising prevalence of diabetes brings with it the critical issue of diabetes distress, which can severely undermine a patient’s motivation for self-care. Global reports suggest that between 18% to 35% of patients suffer from diabetes distress, exacerbating the challenges of living with the disease.
“Diabetes is not just a physical condition; it’s a psychological battle,” says Dr. Javeri-Mehta. “Diabetes distress is a significant concern because it can impair a patient’s ability to manage their condition, adhere to medication, and increase the risk of the very complications that contribute to their anxiety.”
According to the International Diabetes Federation (IDF), 63% of people with diabetes report that the fear of developing complications negatively impacts their wellbeing. Dr. Javeri-Mehta highlights that while the societal trend toward health-focused hyper-tracking can offer valuable insights, it also risks creating the “worried well”—where individuals in good health mistakenly believe they are ill.
“The constant fear of blood sugar spikes, anxiety over developing complications, and obsession with dietary restrictions and tracking devices can contribute to this distress. That’s why it’s crucial to emphasise the importance of diabetes self-management education.”
The American Diabetes Association (ADA) outlines seven pillars of self-care, which are essential for managing diabetes effectively and reducing distress, including healthy eating, being active, monitoring, taking medication, problem-solving, healthy coping, and reducing risks.
Managing Stress helps control blood sugar
Dr. Javeri-Mehta says there is a need to equip patients with the tools and resources to manage diabetes without added stress. When stress builds, it can keep blood sugar levels high, increasing the risk of complications.
“Managing diabetes can be frustrating, especially when readings are erratic, leading to panic and negativity. Much of my work with patients focuses on positive psychology and diabetes education, which play a significant role in overall wellbeing and promoting positive behaviour change in chronic disease management.”
Patients need support from a multidisciplinary team to build resilience, encouraging positive self-talk, self-compassion, and setting realistic expectations about their condition
“We also teach patients how to manage stress through self-care practices that activate the parasympathetic nervous system. The obvious components of a healthy lifestyle, like mindfulness, regular exercise, and proper sleep, also play a crucial role in enhancing diabetes management.”
Fears of complications can be alleviated with routine checks
When diabetes is left unchecked, it can lead to serious health issues like heart disease, stroke, and kidney failure. While these fears are valid, Dr Javeri-Mehta says that they often result in harmful avoidance. “Patients skip routine check-ups because they’re afraid of what they might discover, which only worsens their condition.”
She adds that it is important to prioritise early detection and preventive care through regular visits with healthcare teams. “Education is key to shifting this mindset. With proper support and knowledge, patients can manage their condition proactively rather than being trapped in fear.”
Finding nutritional balance can ease food anxiety
For many people with diabetes, food is a major source of anxiety.
“Patients are terrified that certain foods will spike their blood sugar, but it’s not just about cutting carbs or avoiding sugar—it’s much more complex,” Dr Javeri-Mehta explains.
She notes that there’s no one-size-fits-all approach, and keeping a food diary helps patients understand what works best for them.
“Whole grains, legumes, and healthy fats all support blood sugar control and healthy gut microbiome. We need to move away from seeing any food group as the enemy,” she says. “It’s more about food quality and balance.”
The expert also cautions against disordered eating caused by a fixation on avoiding spikes. “We encourage patients to take a more intuitive approach to eating—understanding how foods affect their bodies while listening to hunger and fullness cues.”
Lifestyle changes can ease diabetes risk concerns in predisposed patients
“Patients often come to me with the belief that because their parents had diabetes, they are destined to get it too. But that’s not always the case,” says Dr. Javeri-Mehta.
Epigenetics – how lifestyle factors influence gene expression – she says, plays a crucial role in the development of type 2 diabetes.
“Even if you have a genetic predisposition, your lifestyle can modify how those genes express themselves. Patients can reduce their risk of developing diabetes through positive changes in diet, exercise, and stress management—an approach rooted in epigenetics.”
Simple Monitoring Can Help Manage Diabetes Without Obsession
Continuous Glucose Monitoring (CGM) devices are popular tools for diabetes management, offering valuable insights for some patients. However, for those with extreme sugar levels, anxiety over numbers, or disordered eating, it can be counterproductive.
“We’re seeing patients become so fixated on glucose spikes after meals that they start restricting food or making decisions based solely on data. A spike is a normal response after a meal, so patients need to understand what that data means.”
Dr Javeri-Mehta adds that healthcare providers play a key role in creating hyperpersonalised plans tailored to individual biology and lifestyle, using continuous feedback.
“We recommend keeping a food and activity diary to track patterns like diet and sleep, which affect sugar levels. This can be done without excessive tracking devices, and discussing these patterns with your doctor can help refine care for better results.”
