Shining a light on the psychosocial impact of diabetes

In this special issue of Diabetic Medicine (June 2018), nine articles are devoted to the psychological, social and behavioural aspects of diabetes management.

By Dr Amelia Lake

Anyone living with diabetes, or supporting a person with the condition, will tell you that integrating diabetes self-care into daily life typically has a negative impact on the social, behavioural and emotional aspects of one’s life – collectively known as the ‘psychosocial impact’ of diabetes. Factors such as anxiety, depression, stigma, and the emotional burden associated with self-care and self-monitoring activities, can act as barriers to optimal self-care, with consequences for long-term outcomes.

Acknowledging and addressing the psychosocial impact of diabetes is an important consideration for all those involved in diabetes care and research. The June 2018 issue of Diabetic Medicine does just that, by dedicating nine articles to some of the leading factors associated with psychosocial burden. Diabetes self-management education and support are cornerstones of diabetes care. Both are considered from a range of perspectives, including an evaluation of the Dose Adjustment for Normal Eating (DAFNE) programme for people with type 1 diabetes [1] and the feasibility of supporting adults living with type 2 diabetes and an intellectual disability [2]. The importance of social support is discussed in regard to the family context in preventing progression to diabetes in women with a history of gestational diabetes [3]. Social support is also researched in the context of reducing diabetes-related distress (e.g. feeling overwhelmed by diabetes, fear for the future, and feelings of guilt or anxiety about getting ‘off-track’ with diabetes self-care) [4]. Relatedly, the effect of peer support for people with type 2 diabetes is evaluated in two studies, which focus separately on reducing diabetes-related distress, and the economic burden of diabetes [5, 6]. Keeping with this focus, another article considers the effect of diabetes-related distress on self-reported medication-taking for people with type 2 diabetes, with the interesting finding that both diabetes distress and perceptions of hyperglycaemia (high blood glucose) are associated with not taking medications as recommended [7].  Finally, two papers highlighting the association between emotional health and diabetes are included. The first, an international collaborative study (including 14 countries), reported that more than one in ten people living with diabetes have a diagnosis of major depressive disorder [8]. In the second, a systematic review and meta-analysis found a bi-directional association between anxiety and incident diabetes, i.e. suggesting that anxiety can lead to type 2 diabetes and vice versa [9]. Editor-in-Chief, Professor Richard Holt, has endorsed the importance of these studies to diabetes research and clinical practice in an editorial [10].

We encourage you to learn more about the psychosocial impact of diabetes by reading the nine papers in this issue of Diabetic Medicine, and we have included links to each article below. You may also like to take a look at this from our own MILES-2 study, which highlights many similar issues for people living with diabetes in Australia. Visit the ACBRD website to access a range of freely available resources to support people with diabetes and assist healthcare professionals in their clinical practice.

Click here to download a copy of the infographic.

Click here to download a copy of the MILES-2 report.

Special issue: Psychosocial impact of Diabetes. Diabetic Medicine, 35(6): 669-824.

  1. Walker GS, Chen JY, Hopkinson H, Sainsbury CAR, Jones GC (2018) Structured education using Dose Adjustment for Normal Eating (DAFNE) reduces long-term HbA1c and HbA1c variability. Diabetic Medicine; 35(6): 745–749.
  2. House A, Bryant L, Russell AM, Wright-Hughes A, Graham L, Walwyn R et al (2018) Randomized controlled feasibility trial of supported self-management in adults with Type 2 diabetes mellitus and an intellectual disability: OK Diabetes. Diabetic Medicine; 35(6): 776–788.
  3. Kragelund Nielsen K, Groth Grunnet L, Terkildsen Maindal H (2018) Danish Diabetes Academy Workshop and Workshop Speakers. Prevention of Type 2 diabetes after gestational diabetes directed at the family context: a narrative review from the Danish Diabetes Academy symposium. Diabetic Medicine, 35(6): 714–720.
  4. Chew BH, Vos RC, Stellato RK, Ismail M, Rutten GEHM (2018) The effectiveness of an emotion-focused educational programme in reducing diabetes distress in adults with Type 2 diabetes mellitus (VEMOFIT): a cluster randomized controlled trial. Diabetic Medicine, 35(6): 750–759.
  5. Ju C, Shi R, Yao L, Ye X, Jia M, Han J et al (2018) Effect of peer support on diabetes distress: a cluster randomized controlled trial. Diabetic Medicine, 35(6): 770–775.
  6. Yu D, Graffy J, Holman D, Robins P, Cai Y, Zhao Z, Simmons D (2018) Impact of peer support on inpatient and outpatient payments among people with Type 2 diabetes: a prospective cohort study. Diabetic Medicine; 35(6): 789–797.
  7. Lum ZK, Tsou KYK, Lee JY-C (2018) Mediators of medication adherence and glycaemic control and their implications for direct outpatient medical costs: a cross-sectional study. Diabetic Medicine; 35(6): 807–815.
  8. Lloyd CE, Nouwen A, Sartorius N, Ahmed HU, Alvarez A, Bahendeka S et al (2018) Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries. Diabetic Medicine; 35(6): 760–769.
  9. Smith KJ, Deschenes SS, Schmitz N (2018) Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta-analysis. Diabetic Medicine; 35(6): 677–693.
  10. Holt R (2018) Psychosocial impact of diabetes. Diabetic Medicine; 35(6): 675-676