As you age with T1D, managing your mental health can become an even more important psychosocial aspect of managing your condition.

Living with type 1 diabetes (T1D) is often described as a full-time job that you can’t quit.

While the daily management remains constant, the emotional and mental health demands of this autoimmune condition can change across different life stages.

People who’ve lived with and managed their T1D for many years, decades even, may become accustomed to a certain level of predictability in how they manage the condition. However, that can change as you get older.

This can relate to changes in insulin needs, foods you enjoy, and whether diabetes complications develop or evolve over time. All of these can take an emotional or mental health toll, individually and collectively.

People diagnosed as children or teenagers may experience different phases of T1D management than those diagnosed as adults with LADA.

Some experience a sort of “rebellion,” where they may not manage as effectively as prescribed. This can lead to higher blood sugars and A1C levels. As time progresses, many who experience this rebellious stage may recognize the need to improve their diabetes care.

Those diagnosed as adults may not experience this phase to the same extent, but it can manifest in different ways — from the honeymoon phase, to learning to manage T1D and eventually as the condition becomes a part of life.

After decades of managing T1D, some adults report developing resilience and self-efficacy that younger people haven’t yet built through their experience with T1D.

But that can change as you get older, especially as your body and diabetes management change more dramatically than they did in earlier years. People with T1D are living longer than they once did, which means many more may experience these shifts in management as they age into their 60s, 70s, 80s, and beyond.

All of this can lead to diabetes distress and burnout, which is a mental health concern of diabetes at any age.

This list isn’t exhaustive, but common T1D issues that may affect mental health for those growing older with the condition can include:

As people with T1D reach 45 years and age into that 65+ demographic, their mental health focus may change from just “everyday management” as they’d known it for many years, to navigating their condition with a changing body and set of life circumstances.

From personal experience, experiencing a wave of new or worsening diabetes complications in the mid-40s feels like a betrayal by my own body.

I’d gotten so used to my T1D management over decades and even recent years of hard work, but everything seemed to cascade at this latest point no matter what I’d done successfully.

This is also where guilt and grief over my early T1D management in my teens and 20s boiled up, leading to more mental health issues.

As people with T1D grow older, it’s important to have a network of people who can offer support in different ways, including daily diabetes management.

Other tips for managing T1D while aging can include:

  • Managing documents ahead of time can become important as you age, and as you let people in your support network know where that information is kept.
  • Keep an In Case of Emergency binder. It should include your current pump settings and rates, your preferred hypo treatments, and contact info for your diabetes care team. Also include your current health insurance plan information and copies of your ID and cards.
  • If managing a pump becomes too complex, don’t view moving back to long-acting insulin pens as a failure. The goal is the most effective management with the least amount of stress.
  • Don’t be afraid to take a “diabetes vacation.” This may be for a day or a week, and with consultation from your healthcare team, may include anything from switching your technology use or not logging sugars as closely as you usually do. Never stop or change medications without first talking that through with your doctor.
  • Progress, not perfection, can become a mantra. Work with your endocrinologist to potentially loosen your A1C and glucose targets. While a 6.5% might have been the goal at 30 years, a goal of 7.0% or 8.0% may be safer
    in later years to prevent dangerous falls or cardiovascular stress caused by hypos. The American Diabetes Association’s yearly standards recognize this possibility for older adults, particularly those with hypo unawareness or existing diabetes complications that may make recognizing highs and lows more difficult. Always consult your healthcare team to discuss individual goals.
  • Find support within the Diabetes Online Community (DOC), including groups like T1D to 100, Grownup T1Ds, or the Joslin Medalist community. Connecting with “50-year medalists” and those who’ve lived with this condition may help keep your mental health in check, providing a psychological boost by connecting with those who get it and can share in these lived experiences.
  • MR completed (MB): accept with no change. There is another new community group if it would be Ok to add www.t1dto100.com

People with type 1 diabetes may experience changes in how they manage mental health as they get older. This can include addressing their diabetes management each day, the foods they eat, and how complications develop or evolve.

Finding support and other coping strategies remain important as you get older with T1D, including for those who may begin experiencing any cognitive decline.