Dr Hermione Price
Consultant Diabetologist, Southern Health NHS Foundation Trust
Jeni Baykoca
Clinical Trials Assistant, Southern Health NHS Foundation Trust
Type 1 diabetes is a life-long health condition, requiring continual self-management. The result of which can have a significant impact on peoples physical and mental wellbeing.
Type 1 diabetes occurs when the pancreas can no longer produce the hormone insulin. People living with type 1 diabetes require life-long treatment with insulin either in the form of multiple injections per day or an insulin pump.
Calculating insulin levels
Each time the person eats they must calculate how much insulin to take. Too much insulin can result in a very low blood glucose level which can result in coma or death and too little insulin can result in a high blood glucose level and acid accumulating in the blood which is a medical emergency. These calculations must consider the carbohydrate content of the food to be eaten but also many other factors including exercise, stress and illness.
It is important that blood glucose levels are kept within a strict range to prevent or delay the onset of diabetes related complications that include heart attacks, strokes, blindness and kidney failure. This continual self-management is very complex and psychologically demanding for individuals.
Impact on mental health
People living with diabetes are more likely to experience mental health disorders, such as depression, stress, anxiety and diabetes distress. On top of this, the combination of diabetes and mental health disorders tend to lead to worse outcomes for both conditions. For example, quality of life is worse, diabetes self-management is impaired, complications are increased and life expectancy is reduced.
People living with diabetes are more likely to experience mental health disorders, such as depression, stress, anxiety and diabetes distress.
It is important to note that there is a low detection rate of mental health disorders in people with diabetes, nearly half of the cases go undetected. Because of this, people who have been diagnosed with diabetes may feel shame and stigma towards them. It is crucial that we address the link between diabetes and mental health.
Reducing stigma and barriers
To improve the mental and physical health of people with diabetes, it has been recommended that people with diabetes receive regular mental health screening and support to treat mental health disorders. However, integrated care of both diabetes and mental health disorders remains poor.
We must increase our understanding of how many people and what type of mental health disorders are being experienced by people with diabetes. This will help to improve health outcomes and care for these people.