Psychosocial aspects of diabetes mellitus
Complex environmental, social, behavioral, and emotional factors, known as psychosocial factors, influence living with diabetes mellitus (DM), both type 1 and type 2, and achieving satisfactory medical outcomes and psychological well-being. Thus, individuals with DM and their families are challenged with complex, multifaceted issues when integrating diabetes care into daily life. To promote optimal medical outcomes and psychological well-being, patient-centered care is essential, defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions”. Lifestyle changes are equally important, in addition to medical interventions in the management of chronic medical diseases or disorders. The impact of DM reaches far beyond the physical symptoms of the disease, often the emotional distress and psychosocial impact on the quality of life of these patients complicates the effective management of their disease. Medical management of DM requires patient implementation of a treatment regimen. Thus, psychosocial factors impacting self-care such as diabetes distress (burdens of DM and its treatment, worries about adverse consequences), lack of social and economic resources, and other psychological states (e.g., depression, anxiety, eating disorders, cognitive impairment), as well as health literacy and numeracy, should be monitored. Evaluation is indicated during major disease and life transitions, including the onset of complications and significant changes in treatment or life circumstances, with prospective monitoring for 6 months. Future direction in diabetic care should be to screen patients early and often and prevent the diabetes distress. This should be considered a priority while developing a treatment plan not an afterthought.