Diabetes care: closing the gap between mental and physical health in primary care.

Abstract

People with diabetes are vulnerable to comorbid mental illness. The burdens and worries of accepting the diagnosis, living with diabetes, adherence to treatment, fear of complications, and fear of hypoglycaemia can result in considerable distress, making diabetes difficult to self-manage.1 As a result, rates of depression and anxiety are higher.2,3 Other mental health problems linked to diabetes include delirium, substance use disorders, psychotic disorders, and eating disorders.4 Comorbidity of diabetes and mental illness is complex and can present as: The combination of mental illness and diabetes is related to worse health outcomes.1–4 Caring for patients with diabetes requires considering emotional and psychological needs together with physical health needs. Management of mental health should be a regular part of diabetes care and be delivered with the same commitment as attending to blood glucose values. Early identification of potential risks and subclinical distress is preferable to waiting for a patient’s mental health or physical health (due to poor mental health) to deteriorate before action is taken. On the other hand, caring for patients with psychosocial issues requires addressing their physical health. A major problem in looking after people with mental illness and diabetes …