IDF21-0117 Psychological intervention in comprehensive care for people with diabetes

Abstract

Background: Diabetes is one of the most relevant global health problems, due to its prevalence, multidimensional biopsychosocial consequences and economic impact on society. This holistic approach favours management, planning and lifestyle changes, which are the main objectives of diabetes intervention. There is increasing recognition that diabetes has psychological consequences that directly affect behavioural management and quality of life and that these aspects need to be addressed as part of diabetes management. People with diabetes require psychological care from the moment the disease is diagnosed. However, in intervention settings, either due to lack of time or absence of professionals, this type of treatment is not offered. Psychological problems are sometimes thought to be less important than physical problems in improving health and people with diabetes are not aware of the importance of psychological well-being in diabetes management. Aim: The aim of this review is to search for references on different randomised studies investigating the efficacy of psychological interventions aimed at treating people with diabetes. Method: A systematic search was carried out in several databases: PsycINFO, Dialnet, Scopus and Web of Science and 1,360 articles were obtained. The PRISMA system was applied, and after eliminating duplicates and theoretical articles, 311 potential articles of interest were left, published between 2017-2021. Subsequently, a critical reading of the clinical evidence found was carried out by applying CASPe to check the efficiency of the search. Results: Eleven articles are randomised controlled trials of which the characteristics of the subjects (sex, age, diabetes, methodological characteristics (sample size, type of design, quality of the study) and the characteristics of the intervention are analysed according to a) the purpose (adherence to treatment, self-management, anxiety, depression), b) the type (cognitive behavioural, problem solving, acceptance and commitment), the mode (group, individual, both) and the style (face-to-face, blended, online). After contrasting the analyses, it has been possible to demonstrate that psychological interventions adapted to diabetes reduce HbA1c and have a positive effect on Mental Health, especially anxiety, stress and depression, improving the capacity for self-management of the disease. Discussion: This review suggests that the identification and management of psychological aspects in people with diabetes is an integral and critical component of their treatment. Psychological well-being has become an important indicator of diabetes control. Further studies should be conducted to thoroughly evaluate the effect of early identification of problems and early referral to appropriate psychological care services. It is also suggested that a simple and effective protocol for providing psychological care in clinical use be developed and the effectiveness of such a protocol examined.