“Over time, most, if not all, type 2 diabetes medications will fail to continue to manage blood sugar, due to the progression of the condition,” says Megan Porter, RD, CDCES, certified diabetes educator in Portland, Oregon. Just as it’s common for type 2 diabetes treatment to stop being effective, it’s also natural for someone to blame themselves and have other negative thoughts when it does happen. If your type 2 diabetes treatment stops working, it’s important to remember that it may simply be a sign that your plan needs a tune-up, not that you’re doing anything wrong. “Type 2 diabetes is always in flux, so it always has to be monitored,” says Howard Pratt, DO, a psychiatrist at Community Health of South Florida, Inc., in Miami, who works with people who have type 2 diabetes. There are many reasons your treatment may stop working, such as diabetes-related health complications or another medication interfering with your type 2 diabetes medication.
The Emotional Toll of Diabetes
Paying attention to your mental and emotional health can be important if you have type 2 diabetes, regardless of whether you experience a setback in your treatment plan. According to the Centers for Disease Control and Prevention, people with diabetes are two to three times more likely to have depression than people without diabetes. And yet, only 25 to 50 percent of people with diabetes who have depression are diagnosed and treated. “Often, the diabetes diagnosis and its acceptance can lead to depression,” Dr. Pratt says. “This is especially so, given that a person has to come to terms with all of the things they must now have to change and monitor.” Here are some common thoughts and feelings you may have when treatment stops working and, more important, what you can do to flip the script and try to work toward a more positive perspective.
1. “It’s my fault my diabetes isn’t under control.”
While there is a lot of emphasis on following a healthy lifestyle to help manage type 2 diabetes — for good reason, since it’s an effective way to help control blood sugar — it can also set people up for disappointment when those changes aren’t enough. “Currently, I think the healthcare system is set up to blame the person, implying that they have failed, so emotionally, they feel like a failure,” Porter says. “Especially with type 2 diabetes, [for which] healthy eating and exercise are usually the first line of defense, when a person fails at that, adding medication on attests to that failure.” Rather than beating yourself up, check in with your doctor to see what needs to change with your treatment plan.
2. “Diabetes is a death sentence.”
“One of the classic pitfalls, and among the worst, is if a person gets to a place where they are resigning themselves to the thought that they are going to die from this condition,” says Pratt. “In reality, the sooner they accept the diagnosis and all of the responsibilities that go with it, the better off they will be.” To help combat this negative thought, it’s important to remember that it’s possible to live a long and healthy life with diabetes. In fact, a study published in May 2020 in the journal PLoS One found that in people with well-controlled type 2 diabetes, there was no reduction in life expectancy compared with people who don’t have the condition.
3. “I’ll never find a treatment that works.”
If your treatment stops working, it may seem like nothing else will ever work again. But try to avoid this all-or-nothing thinking by keeping in mind that finding the right type 2 diabetes treatment often requires trial and error. When something doesn’t work, it just means that your treatment needs to be adjusted. There are many options you may consider: changing your current medication, adding on a medication, or starting insulin or another injectable medication. Work with your doctor to find the treatment plan that’s right for you.
4. “Why bother?”
There’s no question that managing diabetes requires work, and when your efforts aren’t enough to keep your condition in check, it may be tempting to stop trying so hard. But healthy habits like exercising regularly, eating healthy, sleeping well, and limiting alcohol intake are still important in managing diabetes and helping you avoid complications. If they feel too daunting, consider breaking these down into smaller goals. “Try finding one thing you can be motivated to work on, and use that to keep seeing progress,” Porter suggests. And be sure to stick with your treatment and take your medication as directed.
5. “Diabetes is not the only thing getting me down. Everything is hopeless.”
As previously mentioned, diabetes and depression can go hand in hand. And while it’s important to treat both, the good news is that addressing your diabetes may help you emotionally, too. “Until a person can get their diabetes under control, the psychotropic medications that I might prescribe to assist them to manage related mental health challenges will not work that well,” Pratt says.
6. “Nobody understands what I’m going through.”
It can be tough going through challenges with diabetes treatment, especially if your friends and family don’t have the condition or their diabetes is in check. Reminding yourself that there are millions of people with diabetes and some of them are feeling exactly like you are right now might help, as can connecting with others who have type 2 diabetes. “Look for a community of people that can help in supporting you,” Porter says. “You are really not alone in your struggle,” Pratt adds. “This is very treatable, and plenty of people live full lives with this condition.”
7. “I have no control over diabetes.”
When treatment fails, it may seem like there’s nothing you can do about it. But you have far more control than you may realize. “Success with type 2 diabetes is about acceptance, taking your medications, committing yourself to that lifestyle change, communicating with all of your doctors about your medications, and being open to mental health support for the emotional challenges,” says Pratt. There are many avenues for taking control of your type 2 diabetes management. Finally, if you’re struggling emotionally, don’t hesitate to talk to your doctor or a therapist who has experience with people who have diabetes. Your health and happiness are worth it.
