Living with Diabetes Beyond Medicine: Quality of Life, Mental Health, and Self-Management Challenges
DOI:
https://doi.org/10.54536/ajpehs.v4i2.6925Keywords:
Diabetes Distress, Diabetes Mellitus, Health Equity, Integrated Care, Mental Health, Public Health, Quality Life, Self-Management, Social Determinants HealthAbstract
Diabetes mellitus constitutes a major global public health challenge, with far-reaching consequences that extend beyond metabolic dysregulation. While clinical management traditionally prioritizes glycemic control, growing evidence underscores the profound impact of diabetes on quality of life (QoL), mental health, and the sustainability of self-management behaviors. This narrative review critically examines the psychosocial, behavioral, and social dimensions of living with diabetes, integrating evidence from public health, clinical, and behavioral research. The review highlights that diabetes-related distress, anxiety, depression, and stigma are highly prevalent across populations and are closely associated with poor adherence, suboptimal self-care, and diminished QoL. The lifelong demands of diabetes self-management—including medication adherence, dietary modification, physical activity, and continuous glucose monitoring—create a substantial emotional and cognitive burden that can lead to burnout and psychological morbidity. Although digital health technologies and self-management tools have enhanced disease monitoring and patient engagement, they may also contribute to stress and information overload when inadequately supported. Social determinants of health, such as socioeconomic status, health literacy, cultural context, and access to healthcare services, play a decisive role in shaping diabetes outcomes. Financial constraints, limited patient–provider communication, and pervasive societal stigma further exacerbate inequities in diabetes management, particularly in low- and middle-income settings. Evidence indicates that psychological interventions, integrated and multidisciplinary care models, and technology-assisted self-management programs can significantly improve mental well-being, quality of life, and self-care capacity. This review emphasizes the necessity of a holistic, patient-centered approach to diabetes care that integrates mental health support and addresses broader social determinants alongside biomedical treatment. Strengthening public health strategies and health system responses to these dimensions is essential for improving long-term outcomes, enhancing quality of life, and reducing the overall burden of diabetes.
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