Alleviating diabetes distress and improving diabetes self-management through health coaching in a primary care setting

Abstract

Considering the rising global burden of diabetes and its complications, effective interventions for addressing barriers to diabetes self-management are needed. Diabetes distress, a psychological barrier to diabetes self-management, has become increasingly recognised in the literature, but effective and feasible ways of addressing it in routine primary care settings are not known. We present the case of a middle-aged non-Hispanic white American woman with poorly controlled diabetes (haemoglobin A1c (HbA1c): 13.9%) and elevated diabetes distress (baseline Diabetes Distress Scale Score: 2.53) who participated in a health coaching intervention. After the 5-month programme, which included eight 45 minute long sessions with a trained health coach, the patient achieved and sustained a 0.8-point reduction in diabetes distress, an improvement in insulin adherence and a 3.6-point reduction in HbA1c. This case demonstrates a novel approach to managing diabetes distress that entails providing patients a safe, nonjudgemental space to express their feelings and explore challenges with diabetes self-management.

Demystifying diabetes health coaching: A scoping review unveiling the ‘who’ and ‘where’ of health coaching for adults with type 2 diabetes

“…[19][20][21][23][24][25][26][27]32,34,[36][37][38][39]41,43 of the healthcare professionals were already certified diabetes educators or previously completed a health coaching certification. 23,34 In this way, some patients may have more confidence in a coach with a clinical background, as health professionals may focus more on clinical aspects of health rather than self-management support. 48 Ultimately, the cost and availability of healthcare professionals to engage in health coaching may dictate uptake and use.…”

“…Nine study interventions were delivered in 3 months or less 17,18,30,31,[33][34][35][36]43 and 10 interventions lasted 5-6 months. [22][23][24][25]28,29,32,[40][41][42] Seven study interventions were 1 year long, 16,20,21,26,37,38,44 and three interventions were longer than 1 year. 19,27,39 Most studies evaluated the effects of DHC up until the end of the intervention while 31% of studies continued to conduct follow-ups post-inte rvention, 16,21,25,29,[34][35][36][41][42][43] with the furthest follow-up occurring 17-months post-intervention.…”

The “Ups and Downs” of Living With Type 2 Diabetes Among Working Adults in the Rural South

“…These efforts can improve health outcomes, such as reductions in diabetes-related distress and A1C. 10 , 31 , 32 The need for psychological support is a priority, as access to mental health providers disproportionally impacts rural areas compared to urban areas, although rates of depression and diabetes-related distress are similar. 10 , 28 Furthermore, fear and anxiety related to COVID-19 has compounded the level of diabetes distress in this population.…”

The Chinese version of the revised Diabetes Distress Scale for adults with type 2 diabetes: Translation and validation study

“…For each item, scores range from 1 to 6 (1 = not a problem , 2 = a slight problem , 3 = a moderate problem , 4 = a somewhat serious problem , 5 = a serious problem , or 6 = a very serious problem ) [ 20 ]. Each sub-scale was scored separately by averaging the total score of the sub-scale, while the total score is generated by averaging all item responses [ 21 , 22 ]. DD increases as the mean score rises [ 16 ].…”

“…DD increases as the mean score rises [ 16 ]. Because the associations between DDS17 scores and behavioral and biological variables occurred with mean scores of no less than 2.00, an average score of 2.00 is used as the cut-off point to define clinically significant DD [ 22 ]. Precisely, a mean score less than 2.00 indicated “little or no distress,” a mean score of 2.00 to less than 3.00 was considered “moderate distress,” and a mean score equal to or more than 3.00 was considered “high distress” [ 23 ].…”