Let’s Talk: Mental Health & Diabetes
A resource for healthcare heroes
FOR HEALTHCARE PROFESSIONALS
Mental health and well-being are essential aspects of diabetes care. Regardless of your specialty as a healthcare provider, being prepared to discuss mental and behavioral health and proactively screening for concerns is key to facilitating improved outcomes.1
Discussions about diabetes and mental health can often feel stigmatizing, complicated, and even harmful to a person’s relationship with their identity, loved ones, care providers, or diabetes management plan if not considered thoughtfully. This guide can help you navigate these conversations in a more respectful and individualized way, empowering people with diabetes with the tools they need to make informed choices and adapt to changing circumstances.2,3
Choosing stigma-free language
Diabetes stigma and mental health stigma can intersect and negatively impact care outcomes.4 How we talk about mental health can transform the conversation and improve care outcomes. Choose to use language that:
- Is neutral, nonjudgmental, and based on facts, actions, or physiology/biology.1,2
- Is strengths-based, respectful, inclusive, and imparts hope.1,2
- Is person-centered.1,2
- Fosters collaboration between people with diabetes and healthcare teams.1,2
Having stigma-free conversations about mental health
1. Be mindful of past experiences; approach conversations about diabetes and mental health with empathy, compassion, and curiosity.
Aim to meet people where they are and create an environment that normalizes honest discussions around mental health and emotional well-being. Take into account a person’s previous experiences, challenges in diabetes self-management, healthcare access, day-to-day lives, personal health goals, and your own biases around mental health (such as who may or may not be likely to live with a mental health condition or what support they need).
Be proactive with mental health screening, be an active listener, and ask questions that can help guide the conversation and encourage open sharing. Consider inviting the people with diabetes in your care to lead clinical conversations and establish their own goals and priorities with questions like, “What have some of the harder aspects of diabetes management been recently? What would you like to focus on together to make those a little easier?”
When possible, provide evidence-based recommendations and resources. Support people in setting individualized and realistic goals and make an effort to engage in collaborative decision-making. If someone is not close to meeting the current ADA recommendations for physical activity, for example, simply encouraging them to “try harder” and reach those minimum guidelines may not be realistic. Instead, discussing how they could increase their exercise in small increments or by integrating more movement into their daily routine (such as through walking, gardening, dancing, or chores), may be more attainable.
2. Connect people with community support resources and help foster resilience.
Self-stigma or internalized shame and guilt can be a major, but often invisible, challenge of living with diabetes.4 If a person expresses feelings of self-doubt or stigma, prioritize building resilience. Resilience can be described as a person’s ability to adapt to challenging situations and is a powerful tool for supporting a positive self-concept, increasing beliefs in their ability to take care of their diabetes, and defending against diabetes stigma.1,5
Helping people identify things they are doing well in their self-management and reminding them that what they may perceive as “small” actions can add up to positively impact health outcomes can feel encouraging and result in the promotion of behavior change. In addition, engaging with role models, increasing accurate and respectful representations of diabetes in the media, and connecting people with community resources or mental healthcare providers who specialize in promoting resilience can all be beneficial.1,4
3. Acknowledge the challenges and provide referrals.
Discussing mental health can be complicated, especially when additional factors like other physical or mental health conditions, affordability, access, cultural considerations, or pregnancy are involved.
If someone with diabetes mentions that they are having difficulty with their mental health, you can acknowledge how challenging this may be and provide recommendations for speaking with a mental or behavioral health provider who specializes in diabetes and the unique challenges it may pose. Other providers outside of mental healthcare may also be a valuable part of the care team, such as a nutrition professional specializing in diabetes and disordered eating.1
Suggesting mental health treatment can be as simple as including these directories in your after-care summary for every patient, acknowledging that diabetes is tough at times, and pointing them to these resources should they be interested in speaking with someone. Find great provider directories here and here.
This resource was created for dStigmatize, a diaTribe Foundation program, with support from Lilly, AstraZeneca, the Boehringer Ingelheim-Lilly Alliance, and Genentech.
Citations
- American Diabetes Association Professional Practice Committee (2025). 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2025. Diabetes care, 48(Supplement_1), S86–S127.
- Dickinson, J. K., Guzman, S. J., Maryniuk, M. D., O’Brian, C. A., Kadohiro, J. K., Jackson, R. A., D’Hondt, N., Montgomery, B., Close, K. L., & Funnell, M. M. (2017). The Use of Language in Diabetes Care and Education. Diabetes care, 40(12), 1790–1799.
- J, S., T C, S., T, D., T, B., G, K., C, L., R, S., & G, J. (2021). Our language matters: Improving communication with and about people with diabetes. A position statement by Diabetes Australia. Diabetes research and clinical practice, 173, 108655.
- Speight, J., Holmes-Truscott, E., Garza, M., Scibilia, R., Wagner, S., Kato, A., … & Skinner, T. C. (2024). Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. The Lancet Diabetes & Endocrinology, 12(1), 61-82.
- Weissberg-Benchell, J., Shapiro, J. B., Bryant, F. B., & Hood, K. K. (2020). Supporting Teen Problem-Solving (STEPS) 3 year outcomes: Preventing diabetes-specific emotional distress and depressive symptoms in adolescents with type 1 diabetes. Journal of consulting and clinical psychology, 88(11), 1019–1031.