Psychological Aspects of Diabetes

1. Psychological Aspects of Diabetes Key Messages • Significant behavioural demands and challenging psychosocial factors affect nearly all aspects of diabetes management and subsequent glycemic control. • All individuals with diabetes and their families should be regularly screened for symptoms of psychological distress.

2. Psychological Aspects of Diabetes Key Messages • Preventive interventions such as participative decision-making, feedback and psychological support should be incorporated into all primary care and self-management education interventions to enhance adaptation to diabetes and reduce stress.

3. Psychological Aspects of Diabetes 2008 CPG Recommendations • Individuals with diabetes should be regularly screened for subclinical psychological distress and psychiatric disorders (e.g. depressive and anxiety disorders) by interview [Grade D, Consensus] or with a standardized questionnaire [Grade B, Level 2 (39)].

4. Psychological Aspects of Diabetes 2008 CPG Recommendations • Patients diagnosed with depression, anxiety or eating disorders should be referred to mental health professionals who are either part of the diabetes team or are in the community [Grade D, Consensus]. Those diagnosed with depression should be offered treatment with CBT [Grade B, Level 2 (56)] and/or antidepressant medication [Grade A, Level 1A (55)].

5. Psychological Aspects of Diabetes 2008 CPG Recommendations • Multidisciplinary team members with required expertise should offer CBT-based techniques, such as stress management strategies and coping skills training [Grade A, Level 1A for type 2 diabetes (42); Grade B, Level 2, for type 1 diabetes (46)], family behaviour therapy [Grade B, Level 2 (48,53)] and case management [Grade B, Level 2 (43,53)] to improve glycemic control and/or psychological outcomes in individuals with suboptimal self-care behaviours, suboptimal glycemic control and/or psychological distress.