Diabetes is not just about managing blood sugar levels—it's a complex journey of intertwining physical and mental health. From the intricate balance of glucose levels to the psychological toll of managing a chronic condition, individuals with diabetes navigate a multifaceted terrain. In this blog, we delve into the challenges and strategies for the holistic management of diabetes and its mental health ramifications.
Understanding the Complexity
Diabetes affects approximately one in ten people globally, necessitating a nuanced approach beyond mere dietary changes and insulin shots. Managing diabetes is complicated, it takes education, as well as mastering many different skills to control it well. Skills include coping, time management, planning, problem-solving and many lifestyle changes (Cardol et al., 2021). Some people find it difficult to cope with the many changes they need to make to their lives or can become overwhelmed or burnt out over time. The changes in life and lifestyle that come with a diabetes diagnosis can lead to distress, anxiety, and depression (Winkley, et al., 2020).
The Chicken-and-Egg Dilemma
The interplay between diabetes and mental health is intricate. While diabetes increases the risk of depression and anxiety, the reverse is also true. Individuals grappling with diabetes face an array of stressors, from managing dietary restrictions to adhering to medication regimens (Golden et al., 2008). Cognitive Behavioural Therapy (CBT) emerges as a promising intervention, offering tailored approaches to address the unique needs of individuals with diabetes (Safren et al., 2014).
Bridging the Gap with Telehealth
The emergence of digital mental health signifies a transformative phase in diabetes management, effectively bridging the gap between physical and behavioural health.
Online behavioural therapy interventions offer cost-effective solutions, empowering individuals to navigate the intricate landscape of diabetes self-management (Vamos et al., 2009). SilverCloud® by Amwell® Anxiety & Depression Programme for Diabetes exemplifies this paradigm shift, providing evidence-based interventions tailored to the needs of individuals with diabetes. It is designed for those who are looking to develop tools to self-manage their diabetes, understand the relationship between their diabetes, mood, and physical health, and develop more positive ways of thinking.
The Imperative of Integration
Integrated care emerges as the cornerstone of effective diabetes management. By addressing the symbiotic relationship between diabetes and mental health, healthcare systems can mitigate the burden of comorbidities and enhance patient outcomes (NICE, 2009). Through a holistic approach encompassing psychoeducation, behavioural interventions, and self-management support, individuals with diabetes can embark on a journey of empowerment and resilience (Thompson et al., 2011).
Towards a Unified Approach
As we commemorate Diabetes Week 2024, the imperative for a unified approach to diabetes and mental health becomes increasingly apparent. By leveraging evidence-based interventions and embracing innovative models of care, we can forge a path towards holistic wellness for individuals living with diabetes.
References
Cardol, C. K., Tommel, J., van Middendorp, H., Ciere, Y., Sont, J. K., Evers, A. W. M., & van Dijk, S. (2021). Detecting and Treating Psychosocial and Lifestyle-Related Difficulties in Chronic Disease: Development and Treatment Protocol of the E-GOAL eHealth Care Pathway. International Journal of Environmental Research and Public Health, 18(6), 3292. MDPI AG. Retrieved from http://dx.doi.org/10.3390/ijerph18063292
Golden, S.H., Lazo, M., Carnethon, M., Bertoni, A.G., Schreiner, P.J., Roux, A.V.D., Lyketsos, C. (2008). Examining a bidirectional association between depressive symptoms and diabetes. Journal of American Medical Association, 299 (23), 2751– 2759.
NICE (2009). Depression in adults with chronic physical health problem: recognition and management. London: National Institute for Health and Care Excellence.
Safren, S.A., Gonzalez, J.S., Wexler, D.J., Psaraoa, C., Delahanty, L.M., Blashill, A.J., Margolina, A.L. & Cagliero, E. (2014). A randomised controlled trial of cognitive behaviour therapy for adherence and depression (CBT-AD) in patients with uncontrolled type 2 diabetes. Diabetes Care, 37 (3), 625-33.
Thompson, R.D., Delaney, P., Flores, I. & Szigethy, E. (2011). Cognitive-behavioral therapy for children with comorbid physical illness. Child and Adolescent Psychiatric Clinics of North America, vol 20, no 2, pp 329
Vamos, E.P., Mucsi, I., Keszei, A., Kopp, M.S. & Novak, M. (2009). Comorbid depression is associated with increased healthcare utilization and lost productivity in persons with diabetes: a large nationally representative Hungarian population survey. Psychosomatic Medicine, vol 71, no 5, pp 501–48.
Winkley, K., Upsher, R., Stahl, D., Pollard, D., Brennan, A., Heller, S., & Ismail, K. (2020). Systematic review and meta‐analysis of randomized controlled trials of psychological interventions to improve glycaemic control in children and adults with type 1 diabetes. Diabetic Medicine, 37(5), 735-746.
