Type 1 diabetes (T1D) is a life-long condition that affects more than the body — it can also have a profound impact on emotional well-being. That’s why researchers and healthcare providers are prioritizing wraparound care to support both the physical and emotional needs of those living with T1D.

“Mental health awareness is a critical yet often overlooked component of managing T1D,” said Nicole Rioles, MA, Director of Clinical Partnerships at T1D Exchange. This growing recognition is paving the way for more comprehensive care that acknowledges the delicate balance between physical and psychological health. 

Left unchecked, the daily challenges of diabetes management can be overwhelming and lead to diabetes distress and burnout. Let’s take a closer look at what these terms mean. 

 

  • Diabetes distress (DD) is the emotional toll of living with T1D, stemming from the pressures of management and potentially affecting self-care, emotional wellness, and relationships. Research suggests that nearly half of adults with diabetes in the US experience some form of DD characterized by feelings of fear, worry, and guilt. Yet, research found fewer than 1 in 4 were asked how diabetes impacts their daily life. 
  • When the stress of living with T1D leads to diabetes burnout, it can manifest in various ways, from mental and emotional exhaustion to other serious consequences — such as abandoning a diabetes management plan and putting one’s health at risk. 

 

Mental health screening with T1D 

“Beyond the physical demands of constant blood sugar monitoring, insulin dosing, and dietary vigilance, individuals face the invisible weight of diabetes distress — a unique, chronic emotional burden tied to the relentless nature of the condition,” said Rioles.   

“This distress can erode quality of life, disrupt self-care behaviors, and increase depression risk, creating a cycle that jeopardizes both mental and physical health.” Given these risks, routine screening is crucial. By identifying diabetes distress and depression early, clinicians can intervene before symptoms worsen. 

Screening for diabetes distress, in particular, helps identify the emotional struggles that come with managing type 1 diabetes — struggles that are real, valid, and often overlooked, she explained. 

Recent T1D Exchange Quality Improvement Collaborative (T1DX-QI) research evaluated diabetes distress screening practices and found:  

  • Pediatric centers were more likely to screen than adult centers 
  • Just over one-third of T1DX-QI centers were performing DD screening 
  • Only 16% screened their patients annually for DD 

There’s clearly more work to be done. In the T1DX-QI, clinical teams from across the US collaborate and learn from one another, changing their workflows to incorporate mental health screeners into their daily practice.  

The Depression Change Package is an example of a practical tool that helps clinics implement depression screening through quality improvement methods.  

 

Clinical depression vs. diabetes distress 

While depression and diabetes distress can overlap, they are different conditions. Research suggests that rates of diabetes distress are higher than those of depression, although both can occur together.

“Unlike clinical depression, diabetes distress responds particularly well to targeted, diabetes-specific interventions such as peer support, structured education, problem-solving therapy, and collaborative care models,” said Rioles.

She explained that these approaches not only offer emotional support but also improve self-management and reduce burnout while strengthening the relationship between the person with diabetes and their clinician. 

 

The power of screening and conversation 

“When providers screen for diabetes distress, they’re opening the door to conversations and interventions that can directly improve both mental well-being and diabetes outcomes — making it a powerful and highly actionable tool in routine care,” explained Rioles. 

Why does this matter? Early identification enables timely support and intervention for people with diabetes. Rioles emphasized the importance of integrating mental health into diabetes care, saying, “It’s not optional—it’s foundational to effective and compassionate care.” 

If you suspect that you may have diabetes distress or burnout and need extra support, it’s important to reach out to trusted individuals. This includes your care team, friends and family, or others who can help you get the supportive care you need. Here are a few online sources for support as well. 

 

✔️ The Behavioral Diabetes Institute is a valuable resource, providing psychosocial support for clinicians and individuals with diabetes. 

✔️ The American Diabetes Association’s Mental Health Provider Directory provides options for therapists who specialize in supporting people who live with diabetes. 

✔️ Breakthrough T1D offers information on when to seek help and how to find the right professional.