ACBRD at the 28th PsychoSocial Aspects of Diabetes (PSAD) Scientific Meeting
By Dr Eloise Litterbach, Jennifer Halliday, and Karen Pearce
In April, we travelled to the PsychoSocial Aspects of Diabetes (PSAD) conference, in the beautiful city of Wuerzburg, Germany. Chaired by ACBRD’s Prof Jane Speight, the PSAD group is an international network. The aims are to improve the quality and dissemination of psychosocial research in diabetes, and to improve the effectiveness of diabetes care.
This year, the conference included 71 researchers, health professionals and people living with diabetes, from around 16 countries across the world.
On day 1, there was a pre-conference workshop: Diabetes Stigma: we took the pledge. What now? Jane and Jennifer Halliday (ACBRD) and A/Prof Chitra Selvan (Bangalore) gave brief talks about the International Consensus to End Diabetes Stigma and Discrimination and the Pledge to End Diabetes Stigma.
Prof Jackie Sturt (London) and Dr Bryan Cleal (Copenhagen) then facilitated a one-hour group discussion. PSAD members shared experiences of diabetes-related stigma across healthcare, research, and the media, and thoughts about how to reduce it. PSAD members highlighted the need to:
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- Sign the pledge to end diabetes stigma and discrimination if you truly believe in the cause, then take relevant actions into work, community, and life in general, whenever and wherever possible
- Be brave and call out stigma when you see it
- Invite others to consider the way their work, views, actions may contribute to diabetes stigma
- Be patient. International change won’t happen overnight, but keep trying because one voice will eventually convert to many!
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A highlight of the conference was the Anita Carlson Lecture, given by Emeritus Professor Lawrence Fisher (University of California, San Fransisco). He spoke about “Addressing the emotional side of diabetes in clinical care: time for a mini-paradigm shift.” Prof Fisher shared how his views about the emotional side of diabetes and diabetes distress have changed in recent years.
He pointed out that diabetes distress is often thought of as a ‘condition’ or ‘co-morbidity’. But listening to experiences shared by people with diabetes has helped him realise that we need to avoid thinking about diabetes distress in this way. Diabetes distress is not a mental health disorder. It should not be pathologised or diagnosed. Diabetes distress is the emotional side of diabetes. It affects self-care and quality of life, so it must be addressed alongside diabetes management in routine care. He also advised that diabetes distress measures remain useful. But more often than not, we need to look at responses to individual items; and not focus so much on the total score or whether it is above or below a cut-point indicating elevated distress. Any and all diabetes-related distress can be important for the individual. The item-level data give so much more information that can help a health professional to identify how to best support that person.
On day 2, the PSAD community shared their own research, both completed and in progress. ACBRD’s Eloise Litterbach presented our work on stigma in gestational diabetes. She highlighted the many sources and impacts of such stigma. She also presented a new measure, which was developed with women with gestational diabetes.
Day 3 included recognition of the important contributions to the field made by the late Dr Axel Hirsch and the late Dr Bob Anderson. In the 1990s, both had been pioneers of empowerment, which we often take for granted these days. Then, it was time for the 2024 Mark Peyrot Great PSAD debate. PSAD members split into two teams to generate arguments for more psychology versus less psychology in this era of advanced diabetes technologies and treatments. The arguments on both sides were compelling.
The team arguing for ‘less’ asserted that: technologies are reducing the burden of diabetes management; and that artificial intelligence (‘AI’) has the potential to provide tailored support; among many other points. The team arguing for ‘more’ asserted that, while we may not need more psychologists, the need for psychology has never been stronger. This includes upskilling all diabetes health professionals to support the emotional and physical health of people living with diabetes. In the end, the vote favoured the need for more (not less) psychology. Of course, there was bias in the room, but it was a fun, engaging and thought-provoking debate.
The final symposium chaired by Dr Sören Skovlund and Prof Norbert Hermanns explored “How can person-reported outcomes be used to improve person-centred clinical care and research in diabetes?”. Several awards were presented during the meeting, and we extend our congratulations to all recipients. These included:
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- Prof Frank Snoek, who received the PSAD’s first ever Lifetime Achievement award, in recognition of his pivotal role as the founding Chair of the PSAD study group back in 1995, and a highly influential career.
- Dr Pil Lindgreen, who won the 2024 PSAD Science Award.
- Three early career researchers, who won travel fellowships to attend – these included ACBRD’s Eloise Litterbach.
- Two people with lived experience of diabetes, representing the #DEDOC voices, who also won travel fellowships to attend the meeting.
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Our thanks to the 2024 PSAD Conference Local Organising Committee, Prof Norbert Hermanns, Dr Dominic Ehrmann, and Dr Andreas Schmitt. Set among hectares of vineyards and incredible architecture, reflecting the area’s rich history dating back to medieval times, Wuerzburg was a spectacular setting for a productive, informative and fun-filled conference. Bringing so many like-minded people together across the world was fantastic. Both the scientific and social programs offered lots of opportunities to make new connections and strengthen existing collaborations.
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