Diabetic Referred Stress

You say you never heard of "Diabetic Referred Stress?" That's because I just made up the term! But it's a process I've noticed for a while and want to see if anyone else experiences the same thing.

When people ask if we get stressed out about managing Diabetes, I always say no. I just do what I need to do day to day, and often I enjoy the challenge. I do have to confess that I no longer work full time, and live alone so have a pretty free life to do all the daily tasks we all do. Even when something puzzling happens, I usually just post on here, but don't freak out (like when I was expecting a 5.9 A1C and got a 6.9!). Problem to be solved, not a lot of emotional baggage.

But here's what does happen. I get stressed about other, relatively small things, more so than I did pre-D. Here's an example from yesterday/today.Item #1: I received in the mail a letter from Social Security saying they'd overpaid me last year by $1,392 and would I please pay it back in 30 days. What!!?? It did say I could call and make a payment plan so I planned to do it today though thought they'd ask for all sorts of back-up and it would still be more per month than I could afford.Item #2-I got a message from my doctor saying to call her. She said it wasn't urgent. She probably just wants to bug me about tests, which isn't how I like to relate to docs, and I will have to tactfully tell her I decide what to do and not do. Item #3-I woke up today very high. I had a low yesterday (item 3A?) and was a bit disoriented and seem to have underbolused for dinner +glucose). I did what I usually do, no biggie, just "wasted the amount for correction" then went to get a syringe to do a shot. No syringes, I threw out my last one a while back. Darn. So I just bolused on my pump and wrote down that my IOB would be showing double. Item #4- one of the surface unit/burner coils on my stove broke a while ago and I've just been using the other 3. I finally went to Ace with the old one in hand and the guy directed me to a package. I brought it home and it doesn't fit; it says right on it, "not for GE" and the guy never asked what kind of stove. I had a hard time navigating GE's website and finally called to order it.

To conclude, all but the doctor (no return call yet, but I'm sure it's nothing) resolved well. I ordered the part (it was expensive but I'll subtract from my rent). I am nearly back to normal BG and the IOB computation was no big deal for me. The Social Security worked out amazingly; they offered me a 36-payment plan which is painless (I can pay more when I have it), no paperwork requested, and I was off the phone in 10 minutes! Oh and I put insulin syringes for backup on my shopping list.

None of these things were life-rending by any means! The financial one was the only one with the potential to cause me some discomfort (no homelessness or hunger!). And I knew basically they would all work out ok. But I was stressed, stressed, stressed! And the reason I believe is referred stress. The way I see it is even though I'm not stressed by the regular D management, it takes up an enormous amount of real estate in my life and in my mind. It is, as we all know 24/7! (Kudos as always to those who do it along with families, work, school, etc!). So there isn't a lot of space left over and when anything else comes up, or a series of small things all at once like I described above, it spills into stress/over-reaction zone.

Diabetic Referred Stress. Anyone relate?


One's capacity to deal with negative, stressful problems is certainly not unlimited. I like to think of it as a bucket, being filled at the top with water, and a valve at the bottom letting it out.

Each issue/stressor turns the tap on for a bit, filling the bucket some more. Resolution turns on the valve at the bottom letting some out. When a person is emotionally balanced, the bucket doesn't overflow.

D leaves the fill tap on 24/7 at a small trickle, but it's constantly adding to the bucket. It's a problem that never gets resolved, so the outlet valve is never turned on for D. All this diminishes one's capacity to deal with all the other crap life throws at us.

It's so common to hear the term, "overwhelmed" among PWD. That's the bucket spilling over the top. Another way to let some water out of that release valve besides just issue resolution is recreation, exercise, treating oneself to some quiet time, and many more "treatments". For PWD, ensuring these mitigating behaviors are given priority and followed-through on is all that much more important than it is for everyone else.

Love the term, "Diabetic Referred Stress", Zoe!

Never heard it put quite that way, Dave, but it's very apt. I agree about all the "treatments". I have always talked to people about taking "mini-vacations" - little time outs from the stress of living. For me, as PWD, I also find it important to have "goodies" in my life - things that give me pleasure, reward and satisfaction. Without them my life becomes nothing but "managing" and that's not much of a life at all. I also try and limit the amount of time spent on "medical concerns" because as we age, that can take up way too big a share as well.

Hi Zoe: That is an excellent term, "Diabetic Referred Stress"! I would say that diabetes is a "humming along in the background" stress for me. Daily care is a lot of work (not just the testing and bolusing, but also the exercise, home cooking, etc.) and I also work full time and have a busy life. But I can get really frazzled when other stresses in my life overload me--it's an additive effect.

DRS - hmmmm. I think you just had a stress stack!! I'd rename it to Stress Stack Syndrome - or SSS.

I bet DRS will become a new topic and will hit the internets search soon enough and then will be widely used and folks will claim they suffer it. Much like liver dump. LOL

Great perspective Zoe and I think true for anyone navigating through life with chronic illness.

Interesting, Lilli. I had a few friends with serious chronic illness (terminal) and it seemed as though dealing with their own mortality they developed an almost spiritual serenity, as if they really "got" that nothing was all that earth shattering. During the 80s I was around a lot of people with AIDS and that seemed fairly common. But maybe the difference is "chronic" vs "terminal". In a way our chronic illness is more stressful because you have to (to quote "Alice") "run as fast as you can just to stay in one place". That could also account for the high rate of Depression among PWDs - Some view the causes of Depression as either a change in number of "rewards" or "punishments" in ones life, or not feeling like you have any control over rewards and punishments. (perceived helplessness).

I can relate...but if D was not using up part of my band width it would just be something else. My wagon is always overloaded with something, my load is not all bad, most of it is good but the sum total is just to much. I have suffered from something stressful most of my life, School, Dating, Vietnam, A bad mirage, diabetes, liver cancer...whats next...;-)

I have had a full and wonderful life, great career, wonderful second wife, two wonderful children, beautiful grand children....yes I have some bumps and bruises but every morning I thank my Lord for one more day with my family and friends....

If I ever said [small things never bother me] I'd be lying.....

I have a couple of serious chronic conditions to manage and I will agree that I've learned that walking along knowing that nothing is all that earth shattering is the way to look down the road. Terminal illness, chronic condition, these things can take a toll to be sure. But we have choices always in how we deal with things. I choose not to be a whiner and bring others down when I am having a hard time or a bad day...or get some bad news or a bad result. I live each day being thankful for just that. This Day :)

Yes, I think terminal illness is different than chronic illness Zoe. With invisible chronic illness you are always on that treadmill, no end in sight, trying to keep up with the “normal ones”. And depending on the limitations of your particular illness that can be very difficult and very lonely at times. I have a close friend with rheumatoid arthritis and part of why we are so close is we can talk to each other honestly about the realities of living in a body that has forced us to limit our choices at times throughout our lives. Occasionally we take turns venting and whining a little on bad days…then we get over it by counting our blessings!

Haha, it appears I was writing my reply Karen before yours was posted, I must admit, I do whine sometimes:)

No worries. I count my blessings every single day. And I totally understand the need to whine now and then. I call counting my blessings counting my lucky stars, and I am ever blessed I tell ya!!

Good point, John that even clearly positive things can add to stress! There are charts of the things that cause stress in our life, and some of the highest up are positive, but life altering changes like moving, new job, new marriage, etc.

I also find it important to have "goodies" in my life - things that give me pleasure, reward and satisfaction. Without them my life becomes nothing but "managing" and that's not much of a life at all.
That is such an insightful observation it bears repeating!

Too often I feel like I'm just managing my way through life. This topic ties in to something else that gets discussed here regularly, the D/pump/testing/whatever-D-related "vacation".

I think part of it is that we can do something about it. So, if you're not, or not doing enough (which we all hammer ourselves for, regardless of how valid the judgement is), we stress. There's this "background", as Melitta puts it, of constant anxiety about the whole thing. Am I doing enough?

Terminal illness has a finality to it that allows one to "give up" with no consequence. It doesn't matter what they do -- the disease will progress with finality regardless. So, one can forget about everything else, and focus on peace, what they value, and getting the most out of the limited time left.

PWD? We're constantly trying to extend that time, and make the odds of it being enjoyable as high as possible.

Diabetic Referred Stress is a great term. My wife once told a friend that I didn't have time for anything but her, my work, diabetes, and my religious congregation, When we have so few unclaimed resources almost everything feels like a crisis even when it isn't. The referred stress even affects my diabetes choices. I didn't even consider an OmniPod for my last pump because of it's somewhat higher rate of site failures. Every failed site feels like a crisis when it happens even though it really isn't.


I have to disagree that "living" with a chronic illness is more stressful than living with a terminal one. Keep it in perspective, "living" with anything, especially as long as PWDs live now, beats the alternative. And everybody usually has something to deal with. That's life, as the song goes.

Well put, D-twin! I feel like I'm constantly protecting myself from additional stressors, even though I can't explain or justify it to "normies".

I never quite relate to those discussions. For me, neglecting/ignoring my D doesn't feel like a vacation as it would just make me more anxious. I would rather balance that "managing" with other fun and enjoyable things.

I don’t think more or less stressful was the point as much as “different” is in terms of dealing with lifelong chronic illness vs terminal illness. My mother was very healthy most of her life so the choices she made about what her life was going to be like were shaped in great part by her abundant energy and good health. She once told me she didn’t know how I did it, dealt with lengthy periods of poor health over the years. I told her you just keep going forward, try to figure out how you can live your best life in the body you have and hope that things get better. Now don’t get me wrong, there are people that have much worse health than me and I’ve often used their example as inspiration to keep going forward, to count my blessings. But I can also look at the lives of other people and know that I didn’t have the same choices, couldn’t have achieved or experienced the same things because my body just wouldn’t let me. (I’m not talking just about diabetes here, I know many PWD take great pride in what they can do while living with it, for me diabetes is a new health issue and in my case is very manageable.)

When my mom passed away 5 years ago after a year long illness, she was ready. Not because she wanted to die, but because she was so sick, so tired, because sometimes there really are worse things than death. Almost all her choices had been taken away at that point and when I told her it was time to call in hospice I took away her hope too, which actually broke my heart as much as losing her did. Anyway, back to Zoe’s original point, living with any chronic illness on top of the other stressors of life does give us added challenges, our cups runneth over at times for sure! That’s why it’s good to have a place like Tudiabetes to come and hang out, share, and learn from each other. Diabetic Dad also makes a great point, we all have something to deal with, or as a friend of mine says, everybody has “stuff”.

1 Like

I kind of think it's a difference without a distinction. A few inferences were clearly made on here, that terminal illnesses are somewhat "easier."

Look we all have known people in the prime of their lives, with children, who have been taken by pancreatic, breast, or some other cancer or illness. I've known victims who have passed worrying about their kids, spouses, etc. Accepting one's too-soon demise is in no way liberating or easier for those taken from us too soon.

The development of diabetes management over the last several decades is something to be celebrated and embraced. Stresses...sure, but it's a lot brighter than it is darker in it's place on the broad spectrum of illnesses.

1 Like