Diabetes and The Problem with Perfectionism

Perfectionism can be defined as a personality dimension characterized by a constant striving for excessively high standards or flawless performance and is often accompanied by over concern about evaluations of their behavior.

As I prepared to organize my thoughts on this topic, I found article after article emphasizing the risk to our mental health when we strive for perfection. I find this subject such a slippery slope because after all, shouldn’t we strive for excellence whenever we can? Especially when it comes to our health and avoiding the long-term complications of diabetes? Two landmark studies, Diabetes Control and Complications Trial and the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study demonstrated that the risk of complications was dramatically decreased when individuals achieved a glucose exposure of an A1c of <7%. Striving for a lower A1c often correlates with increased risk of low and very low blood sugars. Now, with advancements in continuous glucose monitoring CGM, The Endocrine Society recommends: “For most people with type 1 or type 2 diabetes, a TIR above 70% is recommended. That’s about 17 hours of a 24-hour day.” This means 7 hours a day, we will have blood sugars that are out of our desired range and still be at low risk of developing complications.

Other researchers suggest that perfectionism links with depression, narcissism, eating disorders, and low self-esteem. Perfectionism has also been linked to an increased risk of behavioral addiction problems such as exercise addiction, problematic internet use, and work addiction.  And yet other studies revealed that perfectionism correlates positively with academic achievement, increased self-esteem, and life satisfaction.


As a mental health professional who specializes in diabetes, I operate with extreme caution when my client shares their efforts to achieve perfection in their diabetes. Oftentimes I hear struggles with all-or-nothing thinking, emotional reasoning, and mental filtering out the positive, which all correlate with anxiety and depression. 

Perfectionism is like quicksand – it pushes us to strive hard to reach our goal only to get sucked down into its ugly trap, getting stuck.  You are not alone.  If you have found yourself enticed by perfectionism and are struggling with the toll this has taken on your emotional health, reach out to a professional who has additional training in diabetes.

Kristi Paguio, LMSW, CDCES, CSOWM