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William Polonsky Part 3, Diabetes Distress Vs Depression

In part 3 of this Exclusive Interview, Dr. William Polonsky talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the latest studies regarding diabetes depression and what may actually be going on under the surface.

William Polonsky, PhD, is President and Founder of the Behavioral Diabetes Institute. He is also Associate Clinical Professor in Psychiatry at the University of California, San Diego.

Transcript of this video segment:

Steve Freed:  So you’re very positive on this, CGM, and using it as a treatment, as a therapy. If it’s done properly. Obviously if you just throw it to them, it doesn’t have a meaning because they’re not doing anything when they see the number they’re not reacting because they don’t know how to react. So we are back to education when it comes to diabetes as a key element. The CGM for type 1 diabetics… you know type 1 diabetes is a completely different disease. People get depressed, frustrated, burned out, when it comes to type 1 diabetes, especially if they’re not in control, even if they are in control, because they have to do so much on a daily basis, on a daily hour. How do you talk to those patients? How do you get them out of their depression besides pharmaceuticals?

William Polonsky: I wrote a whole book about diabetes burnout actually, so it’s my favorite subjects. There’s actually some controversy now about whether people with diabetes really are at an elevated risk for depression. They do tend to score higher on depression questionnaires, but some of the more recent data that I’ve been involved in suggests a lot of what looks like depression may actually be diabetes distress. That distinction, while we’re still arguing about that, is important because if it’s really not major depressive disorder but really just people saying I’m overwhelmed and freaked out and frightened and discouraged about this disease; antidepressants aren’t going to fix that. So we have found a couple of things that really make a difference. I would say the most important one is, we do a lot of work on what’s called evidence-based hope, where we think people are pretty discouraged. People are very surprised when we can provide that with real evidence, easy to explain evidence, that with good care, odds are you can have a long and healthy life with diabetes. That’s obvious to you and me I think, but that’s not so obvious to even healthcare providers who aren’t spending full time in diabetes and certainly it’s not obvious to patients. Providing people with not just the scary messages, like here’s what’s going to happen if you don’t take good care of yourself, actually here’s what going to happen if you do take good care and stay engaged with this treatment that there’s no good reason why your life expectancy should be different from someone who doesn’t have diabetes. The risk of long-term complications becomes so incredibly small. Wwe have such good news to share with patients that we don’t tend to do. That sense of hope that we think is the first step that’s often missing that’s really key.

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