Diabetes: The Importance of Psychological Coping

Asahi Shimbun Morning Edition, October 3, 1998

It is estimated that there are seven million people with diabetes in Japan.

Keiichi Kamoshita, who wrote Diabetes Archipelago (published by Joho Center Publishing Bureau) based on his own experience with diabetes, points out from a civilizational perspective that the increase in diabetes correlates with Japan’s period of rapid economic growth.

Diabetes is closely linked to stress. First, everyday stress can be a cause. Simply being diagnosed with an illness carries a stress score of 43 points. Since diabetes is a lifestyle-related disease, the stress during treatment is even higher. To make matters worse, this stress can further exacerbate the condition.

Because diabetes easily leads to a vicious cycle, patients are compelled to develop the ability to cope with stress.

There is a growing number of patients whose diabetic nephropathy has progressed to kidney failure, requiring dialysis. Some walk 8 to 10 kilometers a day to lower their blood sugar and must also adhere to a strict diet. While this can be extremely challenging, there are also regrettable cases where patients reflect on their inability to manage their condition.

The late master director Akira Kurosawa’s Ikiru (1952) depicts the transformation of a middle-aged civil servant, played by Takashi Shimura, who had spent 30 years in an unchanging, monotonous routine—likened to a "mummy"—and how he begins to live meaningfully after learning he has cancer. When he realizes he is isolated not only in society but also within his own family, he goes through a period of confusion and suffering. Eventually, he throws himself into his work with the resolve to create something—anything—of his own.

After fulfilling his wish, he is seen quietly and joyfully singing Gondola no Uta while sitting on a swing in the snow.

It is difficult to avoid all of life’s stresses. Many people with diabetes should strive to become "good copers"—those who deal with and overcome the condition effectively.

It seems the time has come for physicians treating chronic illnesses to collaborate with clinical psychologists and psychiatric staff, taking into account the psychological aspects of their patients’ care.