medwireNews: A substantial proportion of people with diabetes experience negative psychologic consequences, and these issues are predicted by a number of factors including gaps in person-centered care, insulin use, and complications, suggest findings from a Danish national survey.
Speaking at the virtual ADA 80th Scientific Sessions, Soren Skovlund (Aalborg University) said that 8918 people with diabetes took part in the Life with Diabetes 2019 online survey, and the present analysis focused on psychologic impact, access to support and care, and wishes for improvement.
Almost a fifth (19%) of respondents said that diabetes had a negative psychologic impact on their life, agreeing with the statement that “diabetes takes up too much of life” often or all of the time, while 36% said that they were not getting the help they needed for coping mentally with having diabetes. When asked about referral to a psychologist, 18% of participants said they had not had a referral but would like to have the offer.
When the respondents were categorized by diabetes type, the 1980 individuals with type 2 diabetes who did not require insulin had lower levels of diabetes distress, better quality of life (QoL), and less need for a psychologist than the 4420 people with type 2 diabetes using insulin and the 2327 with type 1 diabetes.
“This is not an uncommon pattern that people taking insulin are more negatively affected psychologically,” said Skovlund.
In a multivariate regression model, insulin requirement and the presence of diabetes complications were significantly associated with higher levels of diabetes stress and poorer QoL, while being female and having higher levels of diabetes distress were significantly associated with needing psychologic referral.
On the other hand, having person-centered care, getting the required coping support, and fitting diabetes into daily life were all significantly associated with lower levels of diabetes stress, better QoL, and a lower likelihood of requiring psychologic support.
And in a subgroup analysis of 5438 respondents with available information on work status, those who were out of work had significantly worse diabetes distress and QoL, were more likely to need psychologic referral, and were less likely to experience person-centered care than those who were working or retired.
Taken together, these findings highlight that “negative psychological impact of diabetes is common and associated with important gaps in person-centered care,” and is “especially linked to vulnerable subgroups,” said Skovlund.
He concluded: “A key implication of our study […] is the need to monitor and to improve access to person-centered biopsychosocial care, especially for vulnerable people with diabetes.”
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