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PSYCHOLOGICAL ASPECTS OF DIABETES

PSYCHOLOGICAL ASPECTS OF DIABETES. 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. ADJUSTMENT.

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PSYCHOLOGICAL ASPECTS OF DIABETES

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  1. PSYCHOLOGICAL ASPECTSOF DIABETES 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada

  2. ADJUSTMENT • Stress, inadequate social and family support and poor coping skills hay have a negative impact on self-care and glycemic control. Many children and adolescents have adjustment problems soon after the diagnosis of diabetes. • Individuals (adults and children) and families (especially families of children with diabetes) should be regularly screened for adjustment disorders. • Specific psychological issues identified should be addressed using psychosocial services available within the community.

  3. DEPRESSION • Depression is twice as common in people with diabetes as in the general population and major depression is present in at least 15% of patients with diabetes. • Depression is associated with poorer glycemic control, more health complications, decreased quality of life and increased healthcare costs. • People with diabetes should be screened for depression regularly and those affected should be offered psychological support and/or antidepressant medication.

  4. EATING DISORDERS • Eating disorders are frequently seen in young women and adolescent girls with type 1 diabetes. Those with eating disorders have poorer glycemic control and an increased risk of long-term complications. • High-risk individuals should be regularly screened for eating disorders. Health professionals should ask non-judgmental questions about weight and shape concerns, dieting, binge episodes and insulin omission for the purpose of weight control. • Those with an identified or suspected eating disorder should be referred to a medical team knowledgeable in treating such disorders.

  5. PSYCHOLOGICAL ASPECTS OF DM- RECOMMENDATIONS • Individuals with diabetes should be regularly screened for psychosocial problems, depression and anxiety disorders [Grade D, Consensus] by direct questioning or with a standardized questionnaire [Grade B, Level 2]. • Those diagnosed with depression should be offered treatment with cognitive-behaviour therapy [Grade B, Level 2] and/or anti-depressant medication [Grade B, Level 2].

  6. PSYCHOLOGICAL ASPECTS OF DM- RECOMMENDATIONS • Individuals with diabetes should be regularly screened for psychological problems by open-ended questioning about stress, social support, beliefs about their disease and behaviour that could impair glycemic control [Grade D, Consensus]. • Interventions including ongoing psychological support and reinforcement, coping skills training and family behaviour therapy should be offered as appropriate [Grade B, Level 2]. • Interventions that increase patients’ participation in healthcare decision making should be offered to adults with diabetes [Grade B, Level 2].

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