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Psychosocial care in diabetes


Overview

Psychosocial care for people with diabetes: A position statement of the American Diabetes Association

This article presents evidence-based guidelines for psychosocial assessment and care of people with diabetes.

Summary points
  • Psychosocial care should be integrated with medical care in order to optimize health outcomes and improve quality of life in people with diabetes.
  • People with diabetes should receive training in diabetes self-care skills and the use of technologies until they attain competence, and the diabetes care team should directly and regularly assess these behaviors.
  • Routine monitoring of people with diabetes for diabetes distress is recommended, particularly when treatment targets are not met and/or at the onset of diabetes complications.
  • Routine screening for depressive symptoms is indicated in this high-risk population. In addition, patients should be screened for anxiety if they exhibit worries that interfere with self-management behaviors, or if they express fear, dread, or irrational thoughts and/or show anxiety symptoms such as avoidance behaviours, excessive repetitive behaviours or social withdrawal. If necessary, such patients should be referred for treatment to a mental health specialist.
  • Screening for disordered or disrupted eating when hyperglycemia and weight loss are unexplained by self-reported behaviors is recommended.
  • In youth and emerging adults with diabetes, monitoring of social adjustment and assessment for generic and diabetes-related distress is recommended. 
  • In adults with diabetes, a discussion of life choices that could be affected by diabetes self-management, such as pregnancy and sexual functioning, should be conducted; high-quality relationships with intimate partners who are able to provide diabetes management support improve diabetes-specific and general quality of life, self-management behaviors and metabolic outcomes.
  • Older adults with diabetes are at an increased risk of all types of dementia; screening for mild cognitive impairment or dementia on an annual basis is indicated in this population.
  • People presenting for bariatric surgery should receive a comprehensive mental health assessment and, if psychopathology is evident, postponement of the procedure should be considered.
  • Physicians should take into consideration the lifestyle and emotional status of the individual with diabetes to ensure successful disease management.

Young-Hyman D et al. Diabetes Care. 2016; 39: 2126–2140. doi: 10.2337/dc16-2053

The ADA psychosocial statement: A UK perspective

Medicine Matters diabetes advisory board member Katharine Barnard gives a UK perspective on the ADA's psychosocial position statement (3:11).

Contents

Back to collection

  1. Editorial
  2. Overview
  3. Adherence
  4. Diabetes distress and psychological comorbidities
  5. Disordered eating
  6. Quality of life
  7. Pyschosocial interventions
  8. Self management strategies

  9. Supplementary resource

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