Podcast Summary

Podcast: Taking Control Of Your Diabetes® – The Podcast!
Episode: The Emotional Side of Diabetes with Clinical Psychologist Dr. Bill Polonsky
Hosts: Dr. Jeremy Pettus and Dr. Steve Edelman
Guest: Dr. Bill Polonsky, Clinical Psychologist
Release Date: May 12, 2025

Overview

This episode delves into the emotional and psychological challenges of living with diabetes, focusing on diabetes distress and burnout. Hosts Dr. Jeremy Pettus and Dr. Steve Edelman—both endocrinologists living with diabetes—are joined by renowned psychologist Dr. Bill Polonsky. The discussion covers the spectrum of emotional responses to diabetes, how to differentiate between distress and depression, when to seek help, and practical coping strategies for patients and their loved ones.

Key Discussion Points & Insights

1. The Emotional Toll of Diabetes (00:20–03:00)

• Both hosts recount their personal frustrations and burnout, highlighting the relentless, minute-by-minute demands of diabetes management.
• Quote:
  Dr. Jeremy Pettus [00:53]:
  “I just don't think there's any other disease like it. The minute-to-minute kind of judging. Is your blood sugar high? Is it low?”
• Recognition of how family and even doctors may lack true empathy, contributing to patient distress.

2. Introducing Dr. Bill Polonsky & His Work (03:00–04:39)

• Dr. Polonsky has dedicated his career to the psychosocial aspects of diabetes.
• Early in his career, he realized most patients labeled as “in denial” were in fact overwhelmed, angry, or frustrated about their diabetes, not unaware of it.

3. Defining Diabetes Distress, Burnout, and Depression (06:05–09:37)

• Distress vs. Depression:
  Depression is feeling powerless about life in general, whereas diabetes distress is feeling powerless about diabetes specifically.
• Burnout:
  The extreme end of diabetes distress, where patients “disengage”—stop monitoring, medicating, or paying attention to diabetes.
• Quote:
  Dr. Polonsky [08:42]:
  “Diabetes burnout is sort of the end of the road for diabetes distress... you disengage from diabetes.”

4. The Normalcy of Negative Emotions (11:16–13:51)

• Most people with diabetes will feel some level of distress; it is normal, not pathological.
• Quote:
  Dr. Polonsky [11:16]:
  “If you aren't going through what you guys are talking about... if you don't have that, actually that's weird.”

5. The Power of Support & Community (13:51–15:30)

• Emphasis on not managing these emotions alone.
• Peer connections—be it friends, support groups, or family—are extremely helpful.

6. Who Experiences Distress & Burnout? (15:30–17:29)

• Nearly everyone with diabetes can experience distress or burnout, regardless of type, age, or background.
• Type 1s often face intense technological and physiological challenges, while type 2s often confront shame and stigma.

7. Screening Tools & Resources (16:43–19:16)

• Diabetes Distress Questionnaire available online at diabetesdistress.org.
  • Anonymous; helps individuals gauge their own level of distress.
• The American Diabetes Association’s Mental Health Registry at diabetes.org helps find diabetes-savvy mental health professionals.

8. Bill’s Clinical Approach (20:33–23:35)

• Dr. Polonsky leads with open, non-judgmental questions: “Tell me about what's driving you crazy about diabetes.”
• Normalizing—helping patients see their struggles as common—and introducing hope are key components.
• Success in diabetes is not binary; every small improvement counts.

9. Addressing Hopelessness and the Myth of Perfection (22:50–26:20)

• Many people wrongly think they must be perfect or that anything less means failure.
• Quote:
  Dr. Polonsky [24:33]:
  “You can't be perfect with your diabetes and you don't have to.”
• Every step toward better management, even if it's incremental, matters for long-term health.

10. Involving Partners and Family (27:27–29:14)

• The approach is individualized: Some benefit greatly from involving loved ones, but the decision is up to the patient.
• Effective communication—discussing how, specifically, someone wants to be supported—is vital.

11. Practical Resources & Humor as Coping (30:18–31:41)

• Dr. Polonsky’s site behavioraldiabetes.org offers tools like the “Diabetes Etiquette Card” to facilitate conversation with non-diabetic loved ones.
• Quote:
  Dr. Polonsky [31:24]:
  “Don’t offer unsolicited advice about my eating or any other aspect of my diabetes. It’s not nice.”

12. Signs of Progress & Outcomes (32:30–33:44)

• Improvement shows up as lower distress scores, greater willingness to engage with diabetes management, improved well-being, and sometimes better clinical outcomes.

Notable Quotes & Memorable Moments

• Dr. Jeremy Pettus [00:53]:
  “We don't have people wake up and check their cholesterol in the morning and then take their medicine and check their cholesterol again in 10 minutes... It's just unreal what we ask people to do.”
• Dr. Polonsky [06:25]:
  “We realized this was really the core of what was going on: diabetes distress is about feeling powerless, but not about everything—about diabetes.”
• Dr. Steve Edelman [16:03]:
  “Type ones, we have a lot more stuff to worry about... But type twos, on the other hand, there’s a lot of shame and prejudice toward their weight... everyone has their own areas that cause some mental stress.”
• Dr. Polonsky [22:50]:
  “With good effort and care, odds are pretty good you could live a long and healthy life with diabetes.”
• Dr. Jeremy Pettus [26:05]:
  “The only time your blood sugar is completely flat is when you're dead. Otherwise, everybody has some variability.”

Resources and Where to Get Help

• Self-Assessment:
  diabetesdistress.org – Take the Diabetes Distress Questionnaire to evaluate your own distress.
• Find a Mental Health Provider:
  ADA registry at diabetes.org – Search for diabetes-knowledgeable therapists near you.
• Practical Coping Tools:
  behavioraldiabetes.org – Download resources like the Diabetes Etiquette Card.
• Support Groups:
  Online or in-person peer groups recommended for connection and solidarity.

Timestamps for Key Segments

• 00:20: The frustration and burnout of diabetes management
• 04:39: Dr. Polonsky’s path and early discoveries about diabetes psychology
• 06:25: Breaking down distress, burnout, and depression
• 11:16: The normalcy of feeling frustrated or overwhelmed
• 13:51: The importance of support (friends, loved ones, support groups)
• 17:29: Assessment tools and online resources
• 20:33: Dr. Polonsky’s clinical approach
• 22:50: Addressing hopelessness and providing hope
• 24:33: Success isn’t perfection; every improvement helps
• 27:27: Involving family and loved ones
• 30:18: Resources like the Diabetes Etiquette Card
• 32:30: Markers of patient progress

Takeaways

• You’re not alone: Diabetes distress is normal and common.
• Support matters: Find people who “get it”—either in person or online.
• Small steps count: You don’t have to be perfect; every bit of improvement helps.
• Resources: There are self-assessment tools and registries for mental health providers who understand diabetes.
• Communication is key: Talk to loved ones about how you want to be supported, and don’t be afraid to ask for help.

Hosts’ Final Thoughts:

• Self-recognition and acknowledgment of diabetes-related distress are the first steps.
• Don’t ignore your feelings—seek communication, guidance, or professional help if needed.
• There is always hope for better management and improved emotional well-being.
  Dr. Polonsky [34:17]:
  “You can live a long and healthy life and it’s never too late to engage with your diabetes.”