Preventative Management Practices for Patients with Diabetes and Mental Health Stress

Patients who suffer from mild to extreme mental health stress are less likely to participate in self-care behavior for diabetes. 

Depression and anxiety are common mental health conditions among by patients with diabetes. This research examines the management practices for self-care among patients with diabetes with or without mental stress. Furthermore, the research covers psychosocial concerns and potential self-care interventions for patients with diabetes. Caring for patients with diabetes involves complementary roleplaying by educational specialists to impact the behavioral health of those who have diabetes: for example, caring and educating patients with diabetes to address the emotional impacts on health and well-being outcomes and activate self-management and prevention behavior for individuals who have diabetes. This field is critical in any care plan for patients with diabetes because unrecognized and untreated issues result in undetermined care and obstruction of care management.  

This study assesses the impact of psychological distress among individuals with diabetes by screening the psychological distress using the Kesler Screening Scale to measure the severity of the distress. The model is essential toward understanding the importance of mental health in patients with diabetes as far as self-management intervention is concerned, and the opportunities for improving and assessing the stakeholders’ perspectives. According to the research, patients with diabetes are highly likely to suffer from mental health complications such as depression and anxiety. Therefore, it is recommended to use self-management programs to help participants address physiological health issues associated with mental health.   

The sample used included individuals aged between 25 and 85. According to the findings, patients with diabetes who exhibit mild mental health issues are more likely to recover from the illness by modifying their diet and restricting their intake of foods rich in fats or cholesterol, unlike patients with diabetes without mental stress. On the other hand, patients with diabetes with high mental stress can easily control high cholesterol or fat intake. Furthermore, patients who suffer from mild to extreme mental health stress are unlikely to participate in self-care behavior for diabetes. The methodologies used include data with pooled cross-sections from 2011 to 2016 obtained from the Medical Expenditure Panel Survey. The dependent variables consisted of moderate or intense engagement in physical exercise 5 times a week, going for dilated eye and foot checkups, treatment of diabetes by modifying diet or injecting insulin into the bloodstream, including minimizing high fat or cholesterol intake. Independent variables consisted of patients with diabetes context with or without mental stress. This research was therefore controlled for predisposing and needed factors. The efforts towards promoting good health and mitigation of distress must be included in the management of diabetes of every person: motivational interventions; enhancement of self-efficacy; coping skills to manage stress; and family interventions all contribute significantly. In this context, individuals with diabetes with low or moderate mental health stress have a p-value of less than 0.001 or 0.05 compared to those without mental health stress. Furthermore, individuals with diabetes who are likely to be confident to take care of their illness are more likely to modify their diabetic foods by a p-value of less than 0.001 compared to those who lack utmost confidence. 

This study is interesting and crucial because it incorporates cross-sectional self-reported data. This implies that mental health stress may lead to a lack of engagement in self-management practices. However, the limitations of this study show that mental health stress implies a psychological distress index that is not specific and summarizes monthly activities without actually representing the overall distress in the life of an individual. However, no variables could be observed to distinguish the type or severity of diabetes; instead, the study used self-reported information presented in the cross-section. Therefore, future studies must adopt psychosocial services for patients with diabetes with mental health stress. 

Practice Pearls: 

• The number of comorbidities among patients with diabetes limits their abilities in self-care management. For instance, having mental health comorbidity poses barriers to lifestyle change necessary for diabetes self-care management.  
• Mental health problems like depression and anxiety are significant among patients with diabetes, with their prevalence being twice the rate of non-diabetic patients.  

• Depressive and anxiety symptoms among diabetes patients can lead to negligence in medication, healthy living, and poor glycemic control.  

Comer-HaGans D, Austin S, Ramamonjiarivelo Z, Sherman LD. Preventative diabetes self-care management practices among individuals with diabetes and mental health stress. J Affect Disord. 2022;298(Pt B):24-34. doi:10.1016/j.jad.2021.11.020 

Njideka Aginam, PharmD Candidate, South College School of Pharmacy 

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