A rising A1C is not proof you stopped trying.

If you live with type 1 diabetes and have walked out of an appointment feeling like you failed, this episode is for you. The exhaustion you cannot quite explain has a name, and it is not weakness.

Dr. Arti Thangudu, board-certified endocrinologist and founder of Complete Medicine and Hey Healthy, breaks down diabetes distress: what it is, why it is not depression, why clinicians miss it, and why people living with type 1, and the people who love them, deserve to understand it.

She has been pulling on this thread since a fellowship project on CGM access and distress over a decade ago.

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## 🔍 This episode explores:

• 🧩 What diabetes distress actually is, and how it differs from clinical depression

• 🧩 Why a rising A1C is often distress, not noncompliance

• 🧩 The minute-to-minute mental load type 1 demands, all day, every day

• 🧩 How CGM access can reduce the burden of constant guessing

• 🧩 The well-meaning comments that land like a punch, and what to say instead

• 🧩 Screening tools that take about five minutes, and why they should be routine

• 🧩 What to do if you love someone with type 1

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## 👩 This episode is for you if:

• You live with type 1 diabetes and feel a bone-deep exhaustion that is hard to explain

• Your A1C went up and you were made to feel it was a measure of your effort

• You love someone with type 1 and want to support them better

• You are a clinician who wants to do more than a rushed visit allows

• You want evidence-based clarity, not platitudes---

## ⚖ The bottom line

Diabetes distress is real, documented, and common. It is not weakness or failure. It is the rational response to an irrational daily demand: the constant decisions, the vigilance, the disease that never takes a day off. The distress often comes first, and the A1C follows. People living with type 1 deserve care that sees the whole of them, not just their glucose curve.

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## 🎙 About the Host

**Dr. Arti Thangudu** is a board-certified endocrinologist specializing in diabetes, women's hormonal health, thyroid disease, metabolism, and menopause. She is the founder of Complete Medicine and Hey Healthy and the host of *Endocrine Matters*. She practices evidence-based medicine and cares for the patients who have been told their numbers are a measure of their worth.

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## 📚 Resources Mentioned

• PAID (Problem Areas in Diabetes) scale: a validated diabetes distress screening tool, about five minutes

• Diabetes Distress Scale (DDS): a validated screening tool for diabetes distress

• Continuous glucose monitoring (CGM): reduces the burden of guessing and can lower distress

• Diabetes care and education specialist (DCES): added support for self-management

• Direct care endocrinology: more time and access than a rushed system visit

• Therapist with chronic illness experience, ideally with type 1 familiarity

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## 🔗 Learn More / Connect

🩺 **Complete Medicine**

. sacomplete.com

Dr. Thangudu's clinical practice. Evidence-based endocrinology and women's hormonal health.

📩 **Newsletter + Blog**

. subscribe at https://www.sacomplete.com/complete-medicine-blogClinical context without the noise. Straight to your inbox.

🎙 **Endocrine Matters Podcast**

. new episodes every Wednesday

Subscribe wherever you listen so you never miss a release.

📲 **Instagram**

. @drartithangudu

Daily clinical perspective. Real answers. No wellness-influencer energy.

▶ **YouTube**

. Arti Thangudu MD. https://www.youtube.com/@drartithangudu

Deeper dives on diabetes, perimenopause, thyroid health, and metabolic medicine.

**Subscribe, leave a review, and share this episode with someone who loves a person with type 1.

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## 🎙 About Endocrine Matters

*Endocrine Matters* is a weekly podcast hosted by Dr. Arti Thangudu, board-certified endocrinologist. Each episode brings evidence-based medicine to the questions patients are actually asking. No hype. No misinformation. No "heal your hormones naturally" shortcuts. Just the clinical clarity you deserve. New episodes drop every Wednesday.

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## ⏱ Chapters

00:00 What diabetes distress is, and why it matters

00:03 A personal start: the fellowship CGM project

02:00 Distress vs depression, why the distinction matters

03:30 The minute-to-minute mental load of type 1

05:30 What the data and patients say

06:30 The comments that land like a punch

08:00 Screening, A1C, and what clinicians should do

10:30 For the people who love someone with type 1

12:00 Closing: you deserve to be seen