Diabetes and Mental Health

Diabetes Attitudes, Wishes and Needs Second Study (DAWN2): Understanding Diabetes-Related Psychosocial Outcomes for Canadians with Diabetes

“…If this is not addressed, the psychosocial impact of living with diabetes might be akin to the "elephant in the room." As reflected in the Canadian Clinical Practice Guidelines, if psychological issues are addressed, it tends to take place in the context of screening for the presence of depressive symptoms (23). However, the DAWN2 findings from the Canadian cohort suggest that diabetes distress and interference with life tasks have the biggest impacts on PWDs.…”

“…In the most recent Canadian Clinical Practice Guidelines, a distinction was made between depression as a mental disorder and diabetes distress (23). Diabetes distress is a construct in which the emotional burden is linked to the experience of living with diabetes (24,25).…”

Are Behavioural Interventions Doomed to Fail? Challenges to Self-Management Support in Chronic Diseases

“…This may reduce collaboration, minimize or negate patient expertise and result in labelling. Consider our clinical practice guideline recommendation of screening for depression (17). If screenings indicate that patients are likely to be depressed, HCPs diagnose likely depression.…”

Barriers to Self-Management in Depressed Women With Type 2 Diabetes

“…Thus, the ability for women to care for their own health is challenging given multiple responsibilities and environments that do not support their roles. Further, environmental factors such as limited access to healthcare and availability of diabetes specific disease management programs create challenges to maintain their health (Robinson, Luthra, & Vallis, 2013). A focus group of middle aged women (n = 41, mean age 55 years, 42% African American) living in the Midwestern region of U.S. with T2DM explored the daily issues women face and identified “bearing multiple responsibilities for self and others” as a major theme that negatively affected their moods (depression, anxiety, and anger) and contributed to problems with their self-management (Penckofer et al, 2007).…”

“…In a joint position statement by the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics, family involvement includes: (a) providing support and education to patient’s family and caregiver, (b) assessing patient and family needs for behavioral and psychosocial aspects of informed decision making, and (c) including family members and support systems in education and ongoing support processes (Powers et al, 2017). The Canadian Diabetes Association Clinical Practice Guidelines Expert Committee recommends family therapy should be a component of psychosocial interventions in diabetes care plans (Robinson et al, 2013). In a review of family based interventions for diabetes, 7 of 15 of the included studies had substantial family involvement but only two found improvement in hemoglobin A1C (HbA1c) (Baig, Benitez, Quinn, & Burnet, 2015).…”