Social treatment to diabetes: What improvements should be performed to combat discrimination and alleviate diabetes distress?

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This article was exclusively written for The European Sting by Ms. Rawasi Hamid, a fourth year medical student at Jinzhou Medical University in China. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


Diabetes distress is a range of feelings felt by diabetic patients due to being overwhelmed by living with such a disease that requires life-long and demanding self-management. Those feelings can be guilt, sadness, anger or frustration. If diabetes distress is not managed timely, it can quickly lead to diabetes burnout, where the diabetic patient stops taking care of themselves and their diabetes, such as skipping a number of insulin doses, not checking blood sugar regularly, and even falling into unhealthy habits.

Furthermore, Patients with diabetes seem to have a lower body self-esteem than others, which correlates with the psychological characteristics of diabetes courses. Therefore, further studies are required on the diabetes distress and its association with complications of diabetes to improve patient’s quality of life.

As society, we have an impactful rule to help patients with diabetes to live with the condition, retaining a healthy mind set.

One meaningful step is educational advocacy in all forms of awareness such as TV, sessions and training in schools and colleges regarding the emotional and physical support for diabetic patients, acknowledging the community that the feelings of diabetes distress are completely normal and that they need time to be able to deal with reading their blood sugar levels on a daily basis without having high expectations, and how effective it is to recognize these feelings and get help.

Family and friends must listen and support diabetic patients and constantly let them know that they are by their side, in addition to talking to a psychologist and the care team provides the best support and monitoring for diabetes distress.

In mixed samples of people with diabetes, monitoring diabetes distress routinely with a validated questionnaire and acting on the outcomes in clinical consultations reduced severe diabetes distress and improved general emotional well-being.

Positive psychological factors such as optimism, self-esteem, self-efficacy, have been identified as protective against distress and elevated HbA1c.

The psychological management of diabetes distress depends on the reason for having such negative emotions. For instance, negative emotions may result from limited understanding of diabetes, self-care skills and confidence. In this case the fist-step approach is diabetes education and training to enhance patient skills. However if the emotional problem is due to a personality trait or inappropriate health beliefs, a psychological approach is recommended as well as diabetes team support.

Also, when emotional problems coincide with other issues (e.g. anxiety disorder, eating disorder and/or social problems), it will require an integrated multidisciplinary approach including diabetes health professionals and mental health professionals.

References

https://www.diabetes.org.uk/guide-to-diabetes/emotions/diabetes-burnout

(Kokoszka et al., 2022) https://pubmed.ncbi.nlm.nih.gov/35167598/

(Khashayar et al., 2022) https://pubmed.ncbi.nlm.nih.gov/35915591/

Oxford text book of endocrinology

About the author

Ms. Rawasi Hamid is a fourth year medical student at Jinzhou Medical University in China who is passionate about scientific writing.

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