Most adults with diabetes report emotional distress, but do not discuss it with care team
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Key takeaways:
- Of a group of adults with type 1 or type 2 diabetes, 69% had self-reported anxiety and 65% self-reported depression.
- Most adults said they had never discussed mental health with their diabetes care team.
The majority of adults with diabetes say their diabetes team has never discussed the topic of mental health with them, even though most self-reported feelings of emotional distress, according to survey data published in Diabetic Medicine.
“This report confirms current literature about the high prevalence of emotional distresses amongst people living with diabetes,” Katharine Barnard-Kelly, PhD, chief science officer at Spotlight Consultations Ltd. in Portsmouth, U.K., and professor at the Southern Health NHS Foundation Trust, and colleagues wrote. “In this large participant sample, the most commonly endorsed experiences were self-reported anxiety and depression as well as fear of low blood sugars, low mood and diabetes-related distress.”
Researchers conducted an online survey of adults aged 18 years and older with type 1 or type 2 diabetes living in the U.K. or U.S. Recruitment took place from Jan. 4 to March 13. The survey addressed psychosocial factors associated with living with diabetes. Questions inquired about the participant’s psychological morbidity and diabetes-related burden, including distress, low mood, diabetes-related anxiety and perceived depression. All answers were self-reported and no mental health diagnoses were recorded in the survey.
There were 478 adults who completed the survey (73% women; 91% white), of whom 78% had type 1 diabetes. Emotional distress was widely reported among participants, with 69% self-reporting anxiety, 65% having self-reported depression and 62% reporting fear of low blood glucose.
Sixty-eight percent of adults said diabetes negatively affected their self-esteem. Respondents cited the relentlessness of managing their diabetes and the feeling of not doing enough, followed by a discomfort about diabetes in public as the most common reasons for the lack of self-esteem. Negatively affected self-esteem was more common among those with type 1 diabetes than those with type 2 diabetes (70% vs. 63%; P < .001).
Of the respondents, 62% said their diabetes led to feelings of loneliness now or in the past. Loneliness was more commonly reported in people with type 1 diabetes vs. type 2 diabetes (68% vs. 44%; P < .001). The majority of adults said not knowing anyone else with diabetes and a lack of understanding of the challenges of diabetes by others were why they felt loneliness. However, 93% of respondents said the people important to them in their life were supportive when they needed help with their diabetes, though 90% stated that support included positive and negative aspects.
Of the participants, 57% said their diabetes team never raised the topic of mental-well being with them, 48% reported ever discussing mental health with their diabetes team and 32% said they had mental well-being concerns, but did not discuss them with their team. Of respondents who discussed mental well-being, 30% said they only discussed it in general terms and 13% said they discussed a specific topic or issue. Thirty-four percent of participants reported receiving mental health treatment from their diabetes team while 25% asked for support, but did not receive it. Of the participants, 83% said they would feel comfortable speaking about psychosocial issues with their diabetes team and 81% said they felt that psychological support should be available.
“Of particular concern in this study is the majority of participants who reported their diabetes team did not broach the topic of psychological support during clinical care, unearthing a significant gap in holistic health care for people with diabetes,” the researchers wrote.
Due to the spread of data and a lack of meaningful patterns to the responses, the researchers said they could not propose recommendations for clinical care beyond exploring the psychosocial needs of people with diabetes during visits. They said more studies are needed to examine strategies for integrating psychological support into routine diabetes care.
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