Intimacy & Diabetes. Janis Roszler

You may feel self-conscious about wearing a pump or worry about mood swings that you experience when your blood glucose level goes out of your desired range. If you worry about how your mate feels about you and your diabetes, that can carry over into the bedroom, where accep-tance and communication should be guaranteed. This concern can affect your ability to enjoy and physically react to intimacy.

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      Carl wears an insulin pump. He loves the improved control he gets with it, but doesn’t know what to do in an intimate situa-tion. He read on an Internet message board that some people leave their pump attached to their bodies during sexual activ-ity, but he can’t see doing that. He also can’t figure out what to do about the marks the infusion set leaves on his skin. He isn’t in a committed relationship with anyone who would under-stand. Sometimes his sexual experiences are with individuals whom he has only known for a short time. Many of them don’t even know that he has diabetes. “I don’t want to start giving a diabetes lecture when I am alone with someone. That is not how I want to spend my evening!” He is so worried about this.

      Keeping Your Diabetes a Secret From Your Partner

      Dating can be traumatic as well. You may worry that your date will reject you after learning that you have diabetes. Fortunately, some have discovered a way to handle this situation. See Jennifer’s story in the box on the following page, Positive Attitude Boosts Confidence.

      You May Feel Distressed or Depressed

      People with diabetes are more likely to feel depressed than those who don’t have this disease. Some have clinical depression that is often treated with medication and/or therapy. Others have what experts call Diabetes Distress, an issue that is often misdiagnosed as clinical depression.

      Diabetes Distress

      Eliot LeBow, a diabetes psychotherapist and certified diabetes educa-tor, describes Diabetes Distress as “A combination of emotional burdens and worries that are related to the experience of living with and manag-

      2. Diabetes and Your Feelings17

      “I was always afraid to tell my dates about my diabetes. I used to hide it. I didn’t want them to think I was damaged or that any future with me would be filled with doctors and hospitals. Then, it hit me. I was acting damaged, wasn’t I? I believed that having diabetes was something to be embarrassed about. It is part of me. Just like my red hair. It is who I am—a great lady who just happens to have diabetes. Now, when I date, I don’t flaunt my diabetes, but I don’t hide it either. If I have to take a shot, I pull out my pen and inject right through my clothes. No one even notices. If I need to test my blood glucose level, I whip out my meter quickly and do it. I’ve found that my attitude sets the tone for my date. If I’m relaxed about my diabetes, my date will be, too. If I expect any romance to happen, even simple hug-ging and kissing, I definitely say something or I will worry about it and won’t be able to relax. I don’t want to suddenly have my blood glucose level drop while we are together. And if it does, I want him to understand what the symptoms look like and how he can help me. I just say, “If I look a bit drunk or start to act a little strange, I may be going low, so please get me a glass of juice and I will be back to myself in no time. It doesn’t happen often, so don’t worry.” —Jennifer

      Positive Attitude Boosts Confidence

      ing diabetes.” According to LeBow, you are likely to have Diabetes Dis-tress if you have some or all of the following symptoms:

      You feel sorry for yourself.

      You struggle to complete daily diabetes management tasks.

      You feel an increased level of frustration and exhaustion.

      You check your blood glucose less often or have stopped altogether.

      You isolate yourself from family and friends.

      You feel depressed and hopeless.

      You miss medical appointments.

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      If you struggle with any of the items listed above, ask your health care team to adjust your treatment plan so you feel less overwhelmed. They can also direct you to a qualified mental health professional who can help you relate to your diabetes management tasks more comfortably.

      Accept that you can’t control everything

      Many of us believe that with enough time and effort, we can con-trol everything in our world. That just isn’t possible. Numerous self-help groups use the Serenity Prayer to highlight this message.

      “God grant me the

      Serenity to accept the things I cannot change

      Courage to change the things I can and

      Wisdom to know the difference.” —Reinhold Niebuhr

      Serenity Prayer

      Whether you are spiritually connected or not, focus only on areas in which your efforts can make a difference. Seek help to learn how to ac-cept those areas, such as how your body responds to stressful events that are not under your control.

      Look for support from others with diabetes

      Ask your health care team to suggest a local or online support group. Many exist on the Internet, but not all are moderated by a qualified pro-fessional. Always review suggestions you learn online with your health care team before you try them. They may not be right for you or could even be harmful. Go to https://community.diabetes.org/home to check out the online community board at diabetes.org, the official website of the American Diabetes Association.

      Get support from family and friends

      Even if you do nothing but laugh or chat about the weather, a mean-ingful friendship can help change your mood. It can also give you an opportunity to share daily gripes with someone other than your partner, especially if you think your loved one needs a break from hearing them.

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      Just don’t disclose personal issues to any family member or friend with-out your partner’s permission.

      Keep your blood glucose level in a healthy range

      High and low glucose levels can cause emotional swings and exhaust you. Your partner may find your mood swings challenging as well. It is more difficult to connect romantically with someone whose demeanor can’t be predicted. Ways to accomplish this goal will be discussed in greater detail in Chapter 3.

      Participate in regular physical activity

      Exercise releases endorphins and can help relax your muscles and make you feel more at ease (see some suggestions in Table 1 on the next page). If you are especially stressed in a specific environment, such as your home office, head over to a health club, community center, or park and move! Invite your loved one to join you for your workout, and use this time to strengthen your relationship as well as your body. Think about physical activities the two of you can do together—dance, attend a yoga class, go for a brisk walk, work out at a gym, and, yes, have sex!

      Share your problems with a qualified counselor

      It can be helpful to talk over your relationship problems with a neutral third party. A therapist can help you look at your concerns from a new, healthier perspective and help you react more effectively to challenging situations. They can also help you let go of troubling thoughts and wor-ries that stop you from moving forward. Check out the resources section of this book for sources for therapists and support groups.

      Pray or connect with your church, synagogue, or spiritual group

      Research shows that people who have a spiritual connection handle the challenges of diabetes better than those who don’t. Many people with diabetes have questions that are handled well by spiritual advisors, such as “Why me?” Others enjoy the nurturing environment found in a house of worship. If you haven’t visited a church, synagogue, or mosque in a while