In the United States, 17.9% of individuals are affected by mental illness. 1 Individuals with diabetes are at greater risk for depression and other psychosocial difficulties compared to the general population. Diabetes educators have identified depression, anxiety, diabetes distress, mild cognitive impairment, intellectual disabilities, maladaptive eating behaviors, dementia, and psychotic disorders as mental health conditions most commonly encountered in practice. 2 In a recent survey, most diabetes educators reported feeling somewhat comfortable knowing when to refer a person with diabetes to a mental health professional. 2 A general lack of mental health resources or access to mental health professionals were reported as struggles in the provision of care related to mental health for people with diabetes. 2 Referrals to a psychologist, social worker, or psychiatrist are common interventions for individuals with diabetes who are identified with mental health concerns. However, an appropriate referral does not end the interaction between diabetes educators and individuals identified with these difficulties. Diabetes educators need to be equipped with resources that complement the psychosocial management for people with diabetes. The objective of this paper is to provide diabetes educators with a practical guide to help support persons with or at risk for diabetes and concurrent psychosocial concerns. Psychosocial Considerations for People With Diabetes It is now well understood that the prevalence of comorbid mental health conditions is higher in people with diabetes than the general population. The most common conditions include depression, anxiety, disordered eating/eating disorders, and short-and long-term neurocognitive changes associated with hypo-and hyperglycemia 3 (Table 1).

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Idarucizumab represents an encouraging development in the reversal of dabigatran. Its novel mechanism of action, pharmacokinetics, tolerability, and lack of thrombotic events contribute positively to its use in patients who experience bleeding or for those who require emergent surgery or procedures.

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