PSYCHOLOGICAL ASPECTS OF DIABETES

1
PSYCHOLOGICAL ASPECTSOF DIABETES

• 2003 Clinical Practice Guidelines
• for the Prevention and Management
• of Diabetes in Canada

2
ADJUSTMENT

• Stress, inadequate social and family support and
  poor coping skills hay have a negative impact on
  self-care and glycemic control. Many children and
  adolescents have adjustment problems soon after
  the diagnosis of diabetes.
• Individuals (adults and children) and families
  (especially families of children with diabetes)
  should be regularly screened for adjustment
  disorders.
• Specific psychological issues identified should
  be addressed using psychosocial services
  available within the community.

3
DEPRESSION

• Depression is twice as common in people with
  diabetes as in the general population and major
  depression is present in at least 15 of patients
  with diabetes.
• Depression is associated with poorer glycemic
  control, more health complications, decreased
  quality of life and increased healthcare costs.
• People with diabetes should be screened for
  depression regularly and those affected should be
  offered psychological support and/or
  antidepressant medication.

4
EATING DISORDERS

• Eating disorders are frequently seen in young
  women and adolescent girls with type 1 diabetes.
  Those with eating disorders have poorer glycemic
  control and an increased risk of long-term
  complications.
• High-risk individuals should be regularly
  screened for eating disorders. Health
  professionals should ask non-judgmental questions
  about weight and shape concerns, dieting, binge
  episodes and insulin omission for the purpose of
  weight control.
• Those with an identified or suspected eating
  disorder should be referred to a medical team
  knowledgeable in treating such disorders.

5
PSYCHOLOGICAL ASPECTS OF DM- RECOMMENDATIONS

• Individuals with diabetes should be regularly
  screened for psychosocial problems, depression
  and anxiety disorders Grade D, Consensus by
  direct questioning or with a standardized
  questionnaire Grade B, Level 2.
• Those diagnosed with depression should be offered
  treatment with cognitive-behaviour therapy Grade
  B, Level 2 and/or anti-depressant medication
  Grade B, Level 2.

6
PSYCHOLOGICAL ASPECTS OF DM- RECOMMENDATIONS

• Individuals with diabetes should be regularly
  screened for psychological problems by open-ended
  questioning about stress, social support, beliefs
  about their disease and behaviour that could
  impair glycemic control Grade D, Consensus.
• Interventions including ongoing psychological
  support and reinforcement, coping skills training
  and family behaviour therapy should be offered as
  appropriate Grade B, Level 2.
• Interventions that increase patients
  participation in healthcare decision making
  should be offered to adults with diabetes Grade
  B, Level 2.