Psychological Chara

1. Psychological Characteristics
of Patient with Diabetes

2. What is Diabetes
• Diabetes is a chronic metabolic disorder that impacts physical, social
and mental including psychological well-being of people living with
it.
• Additionally, psychosocial problems that are most common in diabetes
patients often result in serious negative impact on patient's well-being
and social life, if left un-addressed
• Identifying and supporting patients with psychosocial problems early
in the course of diabetes may promote psychosocial well-being and
improve their ability to adjust or take adequate responsibility in
diabetes self-management

3. Psychological Impact of Diabetes
• Having diabetes can take its toll, with the different aspects of
self-management often feeling overwhelming
• The responsibility for managing diabetes lies almost entirely in
the hands of the person with this life-long condition
• People with different types of diabetes often have distinctive
psychosocial needs

4. Impact on quality of life
• The personal costs for those with type 2 diabetes are many. It
can impact on relationships, on working and social life, and on
psychological well-being, with a consequent effect on overall
quality of life.
• Constant monitoring, following a healthy diet and finding time
for exercise can all lead to improved mental and emotional
health
• The opposite may also be true; feeling depressed or anxious
can lead to poor control of diabetes. This has been
demonstrated in many studies and reviewed by Frank Snoek
and his colleagues for The Lancet.

6. Depression
• People with diabetes are up to three times more likely to report
symptoms of depression and these can be debilitating
• Poor mental and emotional well-being can lead to feeling less
inclined to monitor blood glucose levels which then impact on
self-management and diabetes control.
• People who feel depressed often feel lethargic and so are less
likely to exercise.
• Diet is also very often affected with less healthy foods and more
alcohol consumed. In addition, sleep is often affected

7. Symptoms of depression
• Feeling sad/depressed mood
• Lack of interest/enjoyment in daily activities
• Inability to sleep
• Early waking
• Tiredness/lack of energy
• Loss of appetite
• Feelings of guilt/worthlessness
• Recurrent thoughts about death/suicide

8. Emotional Distress
• People with diabetes may also experience diabetes-related
emotional distress and although there is a strong association
between distress and depression, many people only report one
or the other.
• Symptoms of diabetes-related distress include constantly
worrying about blood glucose levels or the risk of getting
diabetes complications, feeling angry about living with diabetes,
and feeling guilty when going off track with managing diabetes
self-care.

9. • Moreover, patients with type 2 diabetes mellitus (T2DM) also have a
two-fold greater risk for comorbid depression compared to healthy
controls, hampering the QoL of patients.[26,27] Research also
indicates that patients with diabetes suffer from high levels of
diabetes-specific emotional stress
• In view of this, it is important to identify and support patients with
psychosocial problems early in the course of diabetes as it may affect
their ability to adjust or take adequate responsibility for self-care.

10. Relationship of psychological stress factors to
the clinical presentation of diabetes
• The biopsychosocial model, which describes psychological stress as a
state of normal tension, preoccupation, and agitation, defines it as a
relationship between environmental parameters and individual
processes of perception and coping with stressors.
• Under stress, numerous metabolic changes including vasoconstriction
in the peripheral vascular system, increased heart rate, increased
muscle activity, and increased production of stress hormones
• Besides, they have also been associated with increased feeling of
vulnerability and activate body to the “fight–flight” response

11. What to do?
• Effective self-management of diabetes is a critical step in achieving
healthy and satisfying life
• However, it requires a great deal of personal motivation and change in
behavior
• Again, to bring the psychological intervention into the existing
treatment regimen, few changes are important at the health-care
delivery points

12. • It is important to incorporate psychological screening and management
at every level of diabetes care
• It is important to sensitize health-care professionals, persons with
diabetes, and their family members about the importance of
psychological screening and intervention along with other advised
treatment
• There must be an advocacy program at the community level to
improve the awareness level of psychological well-being of persons
with diabetes.

13. Conclusion
• The relation between diabetes and psychosocial disorders is
multifactorial. Their coexistence can impact glycemic control, self-
care behavior, and QoL
• The emotional and psychological needs of the patients with diabetes
are often compromised when personal efforts to meet these challenges
fail to succeed, resulting in increased risk of diabetes-related
complications
• Thus, increased understanding of the psychological aspects of the
patient with diabetes would allow clinicians to formulate strategies
focusing on the improvement in diabetes outcomes and reduction of
disease burden.