Including mental health specialists in diabetes care teams improves health outcomes
By Carly Rothschild
Managing diabetes can be complex and challenging. This is especially true for children and teenagers who face unique struggles during this phase of life. Constantly checking blood glucose can be exhausting and annoying. It can leave young people feeling overwhelmed and emotionally drained. Diabetes technologies can help improve health and well-being. But diabetes still affects every aspect of daily life. Children and teenagers with type 1 diabetes must cope with the pressure of keeping on top of everything and feeling ‘different’ from other children and teens.
Feelings of anger, frustration, and embarrassment can affect how people manage their diabetes. They can also lead to unhealthy eating habits, and risky behaviours like smoking or alcohol use. Providing mental health support for young people can contribute to better emotional well-being. It can also help to reduce their risks for diabetes-related complications. Early access to mental health care is key.
Integrated Care Matters
The International Society for Paediatric and Adolescent Diabetes (ISPAD) recommends that children and teenagers with type 1 diabetes and their families should have access to integrated care.
Integrated care means addressing both medical and mental health needs. It also refers to health professionals with different skills (e.g. psychologists, diabetes educators, endocrinologists and general practitioners) working together as a team to provide diabetes care.
Including mental health professionals (such as psychologists and social workers) on the diabetes care team can help children and teenagers to feel supported in working towards their glucose targets. They can also help the rest of the team understand each child’s unique emotional needs.
ISPAD recommends that mental health professionals should be available for regular checkups. They can also provide access to evidence-based therapies, such as counselling and behaviour support.
A recent study conducted by the SWEET group in collaboration with the ACBRD looked at whether integrated care recommendations are put into practice. The researchers also looked at whether providing psychological care improved health outcomes, such as glucose levels. They surveyed 112 diabetes centres across 6 continents
What did they find?
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- 89% of the centres offered some form of mental health support. This included having a mental health professional as part of the diabetes care team or ensuring there were regular psychological checkups and sessions as needed
- Only 4% met all four of the recommended guidelines for accessing mental health professionals.
- Psychological care improves safety. Centres with more access to psychological care had much lower rates of diabetic ketoacidosis (DKA). DKA is a serious condition that happens when glucose levels get too high. The body starts to break down fat for energy, leading to a buildup of acids in the blood. It can be life-threatening.
- Psychological care improves average blood glucose levels. Centres with more access to psychological care often set and reached glucose targets. This means they aimed for a tighter glucose range and were within that range more often.
Where to from here?
This study highlights that prioritising mental health specialists in diabetes care teams can lead to fewer diabetes complications and improve health outcomes. Most diabetes centres offer some mental health support, which is a positive step. However, increasing access to mental health support need to be a priority in diabetes care.
Reference:
Chobot A, Eckert AJ, Biester T, Corathers S, Covinhas A, de Beaufort C, Imane Z, Kim J, Malatynska A, Moravej H, Pokhrel S, Skinner TC and SWEET Study Group. Psychological Care for Children and Adolescents with Diabetes and Patient Outcomes: Results from the International Pediatric Registry SWEET. Pediatric Diabetes; 2023, 8578231. https://onlinelibrary.wiley.com/doi/10.1155/2023/8578231
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