How to address the psychological needs of people with diabetes? — ASN Events
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How to address the psychological needs of people with diabetes? (#42)

Juliana Chan 1
  1. The Chinese University of Hong Kong, Shatin, NT, Hong Kong

Diabetes and depression are closely associated and their co-occurrence can substantially increase the risk of cardiovascular-renal disease and use of hospital resources. Depending on the clinical settings and study populations, 10-20% of patients with diabetes may report depressive symptoms while 30-50% may harbor negative emotions such as distress and anxiety. These negative emotions frequently cluster which can be perpetuated by disabilities or symptoms due to diabetic complications, uncertainties or misconceptions about nature of disease and its prognosis as well demands on self-care, needs of regular follow up and use of long term medications.

 

Using validated questionnaires, we have reported the high prevalence of negative emotions in our Chinese type 2 diabetic patients. These psychological burdens are associated with poor glycemic control, obesity and hypoglycemia, in part due to suboptimal lifestyle and medication non-adherence. In an integrated care program augmented by the web-based JADE Program with issue of personalized reports and empowerment, we reported the benefits of providing ongoing informational support on emotional distress, self care, self efficacy and control of risk factors. In patients receiving additional support from trained peer leaders or community health workers, using telephone calls or during face-to-face visits, we observed further reduction in hospitalization rates. Thus, by changing the care setting, improving workflow and transferring knowledge to nurses, peer supporters and community health care workers, doctors can greatly improve their capacity and efficiency in managing large volume of patients with complex diseases such as diabetes. The combined use of information technology and holistic care also enables the establishment of large databases and cohorts for identifying treatment gaps and assessing cost-effectiveness in order to inform payors and patients to improve the sustainability of this care model.

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