As with all chronic illnesses, diabetes, whether in yourself or a relative, can take an enormous psychological toll, particularly when your diabetes is first diagnosed. This event can be akin to bereavement; you have lost, forever, your former ability to take good health for granted. This is why it's quite common for people with diabetes to experience and re-experience the classic stages of the grieving process – denial, anger, sorrow and, finally, coming to terms with the illness. There is the inevitable feeling of "Why me? What did I do to deserve this?" Then there's the stigma of illness, of feeling "different", and wondering whom you should tell. Altogether, it can add up to a potent cocktail of negative emotions, which can wreak havoc on your psyche just as insidiously, if less visibly, as diabetes can wreak havoc on the body.

GUILT AND FEAR

Feelings of guilt are common, too, because self-care puts the onus squarely on the person with diabetes to take responsibility for his own health. So every time you break your diet, neglect your medication or fail to test your blood, you feel guilty. It sometimes seems that the whole world is in on a conspiracy to make you feel bad. At social functions, you feel you're letting down your hostess if you don't eat the fancy dessert she's slaved to produce. At work, you're frightened you might have a hypo and lose control in front of colleagues. You have to go along every three months to your doctor or diabetes educator and hand in your results, like a child waiting to be told whether he's been good or bad.

It doesn't help that you probably look fine, which can make people insensitive to your problems. If you have leukaemia, everyone is sympathetic because you're so obviously sick and it's not your fault if the treatment hasn't worked. But, if you have diabetes, people sometimes "blame the victim" for failing to manage it properly. All these things can sap the self-esteem of people with diabetes.