Psychosocial aspects of diabetes management: dilemma of diabetes distress

Abstract

Diabetes mellitus (DM) is a debilitating chronic illness with complex pathophysiological, psychological, and quality of life (QoL) implications creating a constant state of turbulence. Some of these interconnections are apparent to healthcare providers and are easily addressed in a routine diabetic clinical care. However, a large number of these hidden factors that interplay with each other and impact on the physical outcomes of DM goes unnoticed by health care providers. This is a frustrating and lonely predicament for DM patients making it very difficult for them to manage their illness well. At times these patients are mislabeled as "difficult patients". In other cases they are considered to have and unnecessarily treated for psychiatric illness like depression, other mood or anxiety spectrum disorders which they may not need. In recent years clinical researcher are making strides in understanding the emotional distress a DM patient may feel and the factors contributing or perpetuating diabetes distress. This article focuses on understanding the diabetes distress and how it impacts our patients, how to screen, assess, treat and eventually prevent it from happening. The paper also attempt to bring out the major differences between diabetes distress and common psychiatric comorbidities of DM including but not limiting to major depressive disorder and other depression spectrum disorders.

Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus

“…An online survey found that almost one-fourth of the studied general Indian public had moderate to extreme depression [ 9 ]. People with diabetes have multiple psychosocial issues, which coupled with the psychological stressors of a pandemic, social distancing, lockdown, and quarantine creates an unsettling situation [ [10] , [11] , [12] , [13] ]. The prevalence of various mental disorders in people with DM is between 20% and 55%, depending on clinical and socio-demographic variables [ [14] , [15] , [16] ].…”

Measuring the Quality of Life in Diabetic Patients: A Scoping Review

“…Diabetes exposes people to both physical (cardiovascular diseases, neuropathy, diabetic foot, stroke, etc.) and psychological complications (e.g., depression and emotional distress); it also has a direct impact on several social aspects and, more generally, on daily life (due to, e.g., glycemic con-trol and changes in dietary habits and in lifestyle) [2][3][4][5]. Indeed, psychosocial factors seem to be, for diabetic patients, better predictors of relevant clinical outcomes (i.e., mortality and hospitalization) than other physiological indexes generally used to assess health status such as HbA 1C [6,7].…”

Evaluate the prevalence of depression in type 2 diabetics with microvascular complications

“…When a diabetic patient is depressed, he/she often conducts self-destructive behaviors such as eating and drinking a lot, which cause the disease to get out of their control. [ 13 ] The results of the Egede et al . [ 14 ] study showed that depressed diabetics compared to nondepressed diabetics receive more prescriptions, use more outpatient care, and their care costs are 4.5 times higher.…”