6.0.0.0 Psychoso­cial Is­sues

6.1.0.0 Overview

Please refer to the ADA po­si­tion state­ment “Psychoso­cial Care for Peo­ple With Di­a­betes” for a list of as­sess­ment tools and ad­di­tional de­tails (187).

Com­plex en­vi­ron­men­tal, so­cial, be­hav­ioral, and emo­tion­al fac­tors, known as psy­choso­cial fac­tors, influence liv­ing with di­a­betes, both type 1 and type 2, and achiev­ing satisfac­tory med­i­cal out­comes and psy­cho­log­i­cal well-‍being. Thus, in­di­vid­u­als with di­a­betes and their fam­i­lies are chal­lenged with com­plex, mul­ti­faceted is­sues when in­te­grat­ing di­a­betes care into daily life.

Emo­tional well-‍being is an im­por­tant part of di­a­betes care and self-‍man­age­ment. Psy­cho­log­i­cal and so­cial prob­lems can im­pair the in­di­vid­u­al’s (188-190) or fam­i­ly’s (191) abil­i­ty to carry out di­a­betes care tasks and there­fore po­ten­tial­ly com­pro­mise health sta­tus. There are op­por­tu­ni­ties for the clin­i­cian to rou­tinely as­sess psy­choso­cial sta­tus in a time­ly and efficient man­ner for re­fer­ral to ap­pro­pri­ate ser­vices. A sys­tematic re­view and meta-‍anal­y­sis showed that psy­choso­cial in­ter­ven­tions mod­estly but sig­nif­i­cant­ly im­proved A1C (stan­dard­ized mean dif­fer­ence -0.29%) and men­tal health out­comes (192). How­ev­er, there was a lim­it­ed as­so­ci­a­tion be­tween the ef­fects on A1C and men­tal health, and no in­ter­ven­tion char­ac­ter­is­tics pre­dict­ed benefit on both out­comes.