The Importance of Addressing Depression and Diabetes Distress in Adults with Type 2 Diabetes

Abstract

People with type 2 diabetes often experience two common mental health conditions: depression and diabetes distress. Both increase a patient's risk for mortality, poor disease management, diabetes-related complications, and poor quality of life. The American Diabetes Association and the U.S. Preventive Services Task Force recommend routine evaluations for these conditions in adults for optimal disease management and prevention of lifethreatening complications. However, barriers exist within primary care and specialty settings that make screening for depression and diabetes distress challenging. Depression and diabetes distress influence diabetes self-care and diabetes control and barriers in clinical care practice that can hinder detection and management of psychosocial issues in diabetes care. This paper highlights opportunities to increase mental health screenings and provides strategies to help providers address depression and diabetes distress in patients with type 2 diabetes.

Continuity of Care and the Quality of Life among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Taiwan

“…Emotional stressors associated with having T2DM have been proven to negatively affect a person’s mental and social well-being [ 44 ]. Depression and diabetes distress can reduce control of HbA1c, blood pressure, and cholesterol, treatment adherence, and overall health among patients with type 2 diabetes [ 45 ]. Medication adherence, disease severity, and depression were also found to be closely correlated with QoL [ 44 , 46 ].…”

Effectiveness of a Psychoeducational Group Intervention Carried Out by Nurses for Patients with Depression and Physical Comorbidity in Primary Care: Randomized Clinical Trial

“…Numerous studies have reported that in individuals with ischemic heart disease (IHD) the prevalence of postinfarction depression is around 27% which is considerably higher than that observed in the general population [ 6 , 7 , 8 , 9 ]. In the case of type 2 diabetes mellitus (DM), depression is associated with a worse quality of life, lower adhesion to pharmacological treatment, greater metabolic decompensation, and decreased preventive self-care irrespective of the individual’s chronic pathology [ 10 , 11 , 12 ]. Other studies with patients suffering from chronic obstructive pulmonary disease (COPD) have observed depression to be an indicator for emergency room care use and hospitalization due to acute exacerbation of the condition, irrespective of its severity.…”

Psychiatric Comorbidities Increase Cost and Length of Hospitalization in Adolescents and Young Adults with Chronic Medical Conditions

“…This finding is consistent with other literature demonstrating decreased disease self-management, increased complications, and increased health care utilization among patients with psychiatric comorbidity. [5][6] We unexpectedly found that hospitalizations associated with epilepsy did not follow this trend, with no significant influence on length of stay and a significantly lower cost in those with psychiatric comorbidity. We believe this may be related to blending of coding accuracy and prioritization when psychiatric and neurologic conditions are both present.…”