Given how much healthcare professionals have to do during diabetes-focused appointments, from checking A1C levels and eye health, to searching for potential foot ulcers, it’s not surprising that some aspects of their patients’ lives are rarely discussed. But if you ask people with the disease, one of the most important challenges is how diabetes affects them – an experience confirmed by findings in the 2013 Diabetes Attitudes Wishes and Needs (DAWN2) second study.
What’s more, 33 per cent of people with diabetes feel anxious about their diabetes, 28 per cent feel diabetes distress (the emotional impact specifically related to diabetes and its management), and 26 per cent feel overwhelmed, according to the Canadian Diabetes Association’s (CDA’s) 2015 Report on Diabetes: Driving Change. With research showing that people with the disease are more likely to suffer from anxiety or depression, it may be time for healthcare providers to spend time addressing the issue.
Twenty-five-year-old Kylie Peacock is from Halifax, and has lived with type 1 diabetes since she was eight years old. She says that while she now has a good team, many of the providers she worked with in the past just focused on the numbers, such as her blood glucose (sugar) targets, “without taking into account the daily stressors that can make attaining these goals difficult.”
Peacock wishes more healthcare professionals better understood the constant pressure of dealing with blood sugar levels and the fear of going too high or low. “Effort doesn’t equal success in every case with type 1 diabetes,” she says. “I try my best every day to keep things managed and sometimes wish healthcare professionals knew the amount of effort I undergo to stay healthy.”
Edmonton-based Donna Graham lives with type 2 diabetes, which can involve similar emotional challenges. She feels lucky to have a supportive medical team, which has been essential in helping her manage the disease. “Living with type 2 diabetes is mentally and emotionally exhausting,” says the 60-year-old, adding that she has had difficulties with her weight, misunderstandings about her diabetes at work, and problems getting adequate coverage for the diabetes medications she needs. “The everyday life of a person living with type 2 diabetes [can] require sacrifices and choices to maintain an acceptable blood sugar level,” she says.
So why are so many healthcare providers overlooking their clients’ mental health? “Healthcare providers are busy, and they have a strong focus on non-mental health issues,” says Dr. Michael Vallis, a psychologist and one of the co-authors of the DAWN2 study, who speaks regularly about this topic for the CDA. But there is a bigger barrier: discomfort. “Healthcare providers often talk about not wanting to ‘open Pandora’s box’ or ‘opening a can of worms’ ”
Another concern? “They fear that the patient will never stop talking, and [that] this will interfere with their ability to manage their clinical time.”
Overcoming these barriers may seem difficult, but Dr. Vallis sees the connection between well-managed diabetes and good mental health as critical. “Diabetes and mental health should not be seen as two separate issues. While it is true that living with diabetes can increase the risk of major depression, the most important observation is that living with diabetes is stressful,” he says.
Finding time to talk about emotional and mental well-being may be a challenge, but doing so can have a major impact on overall patient health. For more information or to read the entire Driving Change report, visit diabetes.ca.