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When diabetes leads to emotional distress

A recent report reveals the emotional and social impact of diabetes. Professor Jane Speight explains the findings.

Woman makes measurement Testing high blood sugar. Diabetes concept glucometer for glucose level blood test in hand

Diabetes can impact more than just physical health. A recent report by the Australian Centre for Behavioural Research in Diabetes shows it can also have an emotional and social impact on Australian adults living with the common condition.

The Diabetes MILES-2 Report aims to support and minimise emotional burdens experienced, and identifies key areas of depression, anxiety and diabetes distress among respondents.

As Professor Jane Speight, Foundation Director of the ACBRD, explains, “This survey reveals that Australian adults with diabetes face social challenges, including diabetes-related stigma, and a lack of social support for their diabetes self-management and coping.”

What are some of the mental health impacts for those with diabetes?

The MILES-2 survey found that a quarter of adults with diabetes experience moderate to severe depressive symptoms. Also, we found that around one in five adults experience severe diabetes distress, which studies show can lead to depressive symptoms.

This suggests people may not have clinical depression, but the experience of living with and  anaging diabetes can be an emotional burden. This might include feeling down about daily injections or blood glucose checks, frustration when diabetes management gets off target, feeling isolated when others don’t comprehend the burden and extent of the disease, and even feelings of being judged or discriminated against because of their condition.

If diabetes distress becomes severe it can lead to diabetes burnout, where the person disengages completely from their diabetes management. This can have severe consequences for both physical and emotional wellbeing. Health professionals need to be aware of this so they can help people recognise how they are feeling about their diabetes and offer the right support.

How will your research impact treatment for people with diabetes?

The findings of this research will enable us to build on our knowledge and facilitate better tailored interventions to support adults in need. The first survey of this kind (conducted in 2011) led to three key achievements:

  • Screening for diabetes distress. The Royal Australian College of General Practitioner (RACGP) recommended an annual screen for diabetes distress in the management of type 2 diabetes. This can prevent the development of more severe emotional reactions, and better equip health professionals in treating the holistic concerns of the person with diabetes.
  • Handbook for Health Professionals. In collaboration with the National Diabetes Services Scheme (NDSS), a Handbook for Health Professionals was developed to enable them to provide better support. The handbook addresses key psychological concerns affecting Australian adults with diabetes, and provides health professionals with practical skills and resources for managing such concerns.
  • Diabetes fact sheets. The NDSS also developed freely available fact sheets for people with diabetes, providing information about identifying emotional and mental health concerns, as well as practical skills and resources for managing each.

While the impact of those resources has yet to be seen, they are quite recent developments and we hope the latest findings are a timely reminder that more clinical support is needed for people living with diabetes.

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Living with diabetes – key findings

  • A substantial minority of respondents reported moderate to severe depressive and anxiety symptoms (21 36% and 13-21% respectively), particularly in those with insulin-treated type 2 diabetes.
  • Severe diabetes distress (emotional burden, worry and stress related to their condition) was found among many respondents (24% with type 1 diabetes, 20% with insulin-treated type 2 diabetes, and 11% with non-insulin-treated type 2 diabetes).
  • Diabetes-related stigma was common among all respondents. This involves the perception/ experience of being blamed, negatively judged or being treated unfairly due to having/ managing diabetes.
  • Most respondents (89%) have never been part of a peer support group, but many (38%) expressed a desire to be in the future.
  • Just like the general Aussie population, respondents reported eating healthily on five out of seven days of the week. However, healthy behaviours can be more critical for condition management in those with diabetes, resulting in one in three respondents identifying aspects of self-care a ‘considerable’ or ‘great burden’ (especially those with insulin-treated type 2 diabetes).

Find out more at the National Diabetes Services Scheme.

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