Due to its chronic nature, often arising out of endocrinological causes, diabetes is known to increase risk of other diseases such as heart disorders, clots, strokes and even kidney diseases.

The disease’s effects on mental health are two-fold – the physiological imbalance of blood glucose levels lead to various mental and physical effects and disorders arising out of the stress and in some cases, trauma of dealing with a chronic disease.

Some symptoms of blood sugar imbalance are as follows:

• Confusion

• Hunger

• Feeling tired or having low energy

• Co-ordination and decision-making difficulties

• Aggression and irritability

• Difficulty thinking clearly and quickly

• Personality or behavior changes

• Concentration difficulties

• Feeling nervous

Changes in blood sugar level can affect a person’s mood and mental status. When blood sugar returns to a normal range, these symptoms often resolve.

Most diabetes diagnosis are not a fatal threat to health. However, a person must make wholesale changes in his lifestyle to manage the disease. It can also seem like a threat to a person’s way of life.

In order to manage diabetes, a patient needs to make changes to their daily routine.

Standard diabetes management or treatment plan typically includes changes in diet by eating only certain kinds of foods, avoiding high sugar drinks and even restricting alcohol intake which can be difficult for anyone regardless of a diabetes diagnosis.

Diabetes management also involves daily chores like tracking blood glucose and insulin which can be difficult to maintain at the start. Moreover, the expenditure for appropriate care may be burdensome.

Doctors often refer to this condition as Diabetes Distress.

While research is ongoing to gain a deeper understanding of the causes for mental health disorders arising out of diabetes, Dr Parikh explained, “some of the causes maybe attributed to the genetic makeup but diabetes treatment can also induce stress among patients as they are required to make major changes in both their occupational and private lives.”

Dr Parikh suggests that all patients diagnosed with should be recommended for a mental health screening as well.

While this is a widely implemented SOP (Standard Operational Practice) across urban healthcare centers, the same needs to be followed while treating diabetes for the underprivileged.

Civil society organizations like Smile Foundation have been working constantly to drive access to quality healthcare for people from the marginalized sections of society.

For example, the organization’s “Health Cannot Wait” campaign provides telecounselling services.

Through this initiative, Smile Foundation helps connect health experts to people in order to encourage health seeking behavior by maintaining a healthy lifestyle. This can be a powerful tool for screening and raising awareness for mental health.

These initiatives can also help treat diabetes and diabetes distress more effectively.

According to Dr Parikh the best way to effectively deal with diabetes distress is “early identification and early intervention.”

It is critical to diagnose and therefore start the treatment of a patient either through counselling or medication as early as possible.

Moreover, only 25 to 50 percent of people with diabetes who have depression get diagnosed and treated.

A study in the US revealed that up to 45 percent of mental health conditions and cases of severe psychological distress go undetected among patients being treated for diabetes.

On this World Diabetes Day, we must raise awareness regarding the difficulties and stress of managing diabetes and adhering to treatment while also understand the behavioral changes and symptoms that glucose imbalance can trigger.

Effective early screening and swift intervention is key to improving a patient’s health in the long run.

(The author is a lawyer turned business intelligence consultant turned chef. He also designs weekly and monthly meal plans for clients and conducts baking and cooking workshops.)