For 19-year-old Sebastian Harris, the constant pressure to be carefully managing his type 1 diabetes can feel overwhelming.
"I sometimes feel that no matter what I do, my diabetes can be extremely hard to control," Mr Harris said.
"Some weeks my blood glucose levels can be unreasonably low or unreasonably high and it doesn't make any sense, no matter what you do.
"It makes me question whether I am managing it well. I know in the long run it will be fine but, in that moment, it's hard not to feel defeated."
Mr Harris, from the Gold Coast, was diagnosed with type 1 diabetes three years after his younger brother learned he had the same condition.
"You want to switch off and forget about it, but you can't do that with diabetes," Mr Harris, an ambassador for Diabetes Queensland, said.
"There's no holiday from it. The consequences if you do try to ignore it can be life-threatening.
"We need to make sure people are aware of the issues, both physical and mental."
According to data from Diabetes Australia, almost 700,000 people living with diabetes experience a mental or emotional health challenge every year.
Diabetes Australia Group CEO Justine Cain said diabetes mental health was the most prevalent, yet least recognised, diabetes complication.
"Concerningly, the latest figures show that about 400,000 people living with diabetes report difficulties accessing mental health care," Ms Cain said.
"That's a lot of people who aren't getting the help and support they need."
Using National Diabetes Week (July 10 - 16) to highlight the issue, Ms Cain called on Australians to rethink how they viewed diabetes.
"More than 1.1 million Australians report being blamed or shamed for living with diabetes and more than 360,000 say this impacts their ability to live well with the condition," she said.
Better community awareness of mental health challenges like diabetes distress and burnout and encouraging people with diabetes and their doctors to discuss their mental health would help.
"Diabetes mental health challenges are widespread, but they are rarely discussed as part of routine diabetes care," Ms Cain said.
"They really are a silent diabetes complication."
Dr Gary Deed, a GP who provides healthcare to people living with diabetes, said living with diabetes can be "complex and unrelenting".
"That daily management, on top of the worry about long-term diabetes-related complications, can become a real burden," Dr Deed said.
"It's important that health professionals understand the reality of living with diabetes and I'd encourage people working in the field to undertake relevant training to support all people with diabetes."
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