Why Early Psychological Attention for Type 2 Diabetics Could Contribute to Metabolic Control

Open access


Background and aims: Type 2 Diabetes Mellitus (T2DM) is currently a public health emergency that requires inter- and multidisciplinary medical services. The principal aim of the present work was to review the basic factors related to the possible advantages of providing early psychological attention to T2DM patients as a coadjuvant for achieving adequate metabolic control.

Material and methods: A literature review was conducted to explore the interaction between stress and depression and the relation of both to the ability of T2DM patients to effectively manage their disease. Results: It was found that stress is one of the factors linked to the etiology of depression, which is a disorder with high prevalence in diabetic patients. Consequently, an inter- and multidisciplinary approach to treating diabetic patients was developed. One of the main focuses of this approach is early psychological attention, starting shortly after the initial diagnosis.

Conclusions: The ability to create consciousness among health care professionals about the importance of early psychological attention for T2DM patients under an inter- and multidisciplinary strategy could possibly improve pharmacological adherence, metabolic control, the quality of life and the life expectancy of patients, as well as save economic resources for patient families and health institutions.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. International Diabetes Federation. 7th IDF diabetes atlas Brussels Belgium 2015 pp 1-144. Accessed at: http://www.diabetesatlas.org

  • 2. Ferrari AJ Charlson FJ Norman RE et al. Burden of depressive disorders by country sex age and year: findings from the global burden of disease study 2010. PLoS Med 10: 1001547 2013.

  • 3. Vos T Flaxman AD Naghavi M et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859): 2163–96 2012.

  • 4. Lund C De Silva M Plagerson S et al. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet 378: 1502–1514 2011.

  • 5. López MI Rodríguez HM. Propuesta de intervención para ancianos deprimidos. Rev Cub de Med Gen Integ 15: 19-23 1999.

  • 6. Haroz EE Bass J Lee C et al. Development and cross-cultural testing of the International Depression Symptom Scale (IDSS): a measurement instrument designed to represent global presentations of depression. Glob Ment Health (Camb) 4: 17 2017.

  • 7. Khuwaja AK Lalani S Dhanani R Azam IS Rafique G White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr 2: 72 2010.

  • 8. Nichols L Barton PL Glazner J McCollum M. Diabetes minor depression and health care utilization and expenditures: a retrospective database study. Cost Eff Resour Alloc 5: 4 2007.

  • 9. Park CY Kim SY Gil JW Park MH Park JH Kim Y. Depression among Korean adults with type 2 diabetes mellitus: Ansan-Community-based Epidemiological Study. Osong Public Health Res Perspect 6(4): 224–232 2015.

  • 10. Rodríguez Calvín JL Zapatero Gaviria A Martín Ríos MD. Prevalence of depression in type 2 diabetes mellitus. Rev Clin Esp 215: 156-164 2015.

  • 11. Bąk E Marcisz C Krzemińska S Dobrzyn-Matusiak D Foltyn A Drosdzol-Cop A. Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus. Int J Environ Res Public Health 14(9): 1073 2017.

  • 12. Kovacs M Goldston D Obrosky DS Scott MS Bonar LK. Psychiatric disorders in youths with IDDM: rates and risk factors. Diabet Care 20(1): 36-44 1997.

  • 13. Yekta Z Pourali R Yavarian R. Behavioural and clinical factors associated with depression among individuals with diabetes. East Medi-terr Health J 16: 286–291 2010.

  • 14. Trucco Marcelo. Stress and mental disorders: neurobiological and psychosocial aspects. Rev chil neuro-psiquiatr 40: 8-19 2002.

  • 15. Egede LE Zheng D Simpson K. Comorbid depression is associated with increased health care use and expenditures in individuals with diabetes. Diabetes Care 25(3): 464-470 2002.

  • 16. Knol MJ Heerdink ER Egberts AC et al. Depressive symptoms in subjects with diagnosed and undiagnosed type 2 diabetes. Psychosom Med 69(4): 300-5 2007.

  • 17. Zhang CX Tse LA Ye XQ Lin FY Chen YM Chen WQ. Moderating effects of coping styles on anxiety and depressive symptoms caused by psychological stress in Chinese patients with Type 2 diabetes. Diabet Med 26: 1282-8 2009.

  • 18. Vanitallie TB. Stress: a risk factor for serious illness. Metabolism 51: 40-45 2002.

  • 19. Briones A Gagno S Martisova E et al. Stress-induced anhedonia is associated with an increase in Alzheimer’s disease-related markers. Br J Pharmacol 165(4): 897-907 2012.

  • 20. Steptoe A Hackett RA Lazzarino AI et al. Disruption of multisystem responses to stress in type 2 diabetes: Investigating the dynamics of allostatic load. Proc Natl Acad Sci U S A 111: 15693–15698 2014.

  • 21. Carvalho LA Urbanova L Hamer M Hackett RA Lazzarino AI Steptoe A. Blunted glucocorticoid and mineralocorticoid sensitivity to stress in people with diabetes. Psychoneuroendocrinology 51: 209–218 2015.

  • 22. Joseph JJ Golden SH. Cortisol dysregulation: the bidirectional link between stress depression and type 2 diabetes mellitus. Ann N Y Acad Sci 1391: 20-34 2017.

  • 23. Saleh F Mumu SJ Ara F Hafez MA Ali L. Non-adherence to self-care practices and medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study. BMC Public Health 14: 431 2014.

  • 24. Ciechanowski PS Katon WJ Russo JE. Depression and diabetes: impact of depressive symptoms on adherence function and costs. Arch Intern Med 160: 3278-3285 2000.

  • 25. González JS Safren SA Cagliero E et al. Depression self-care and medication adherence in type 2 diabetes: relationship across the full range of symptom severity. Diabet Care 30(9): 2222-2227 2007.

  • 26. Simon GE Katon J Lin EH et al. Cost-effectiveness of systematic depression treatment among people with diabetes mellitus. Arch Gen Psychi 64: 65-72 2007.

  • 27. Katon W. Depression and diabetes: unhealthy bedfellows. Depres Anxi 27: 323-326 2010.

  • 28. American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care 36: 1033–1046 2013.

  • 29. Johns TS Yee J Smith-Jules T Campbell RC Bauer C. Interdisciplinary care clinics in chronic kidney disease. BMC Nephrology 16: 161 2015.

  • 30. Chapman A Yang H Thomas SA Searle K Browning C. Barriers and enablers to the delivery of psychological care in the management of patients with type 2 diabetes mellitus in China: a qualitative study using the theoretical domains framework. BMC Health Serv Res 16: 106 2016.

  • 31. Trovato GM Catalano D Martines GF et al. Psychological stress measure in type 2 diabetes. Eur Rev Med Pharmacol Sci 10: 69-74 2006.

  • 32. Zhang CX Tse LA Ye XQ Lin FY Chen YM Chen WQ. Moderating effects of coping styles on anxiety and depressive symptoms caused by psychological stressin Chinese patients with Type 2 diabetes. Diabet Med 26: 1282-8 2009.

  • 33. do Rosário Pinto M Parreira PMDS Basto ML Dos Santos Mendes Mónico L. Impact of a structured multicomponent educational intervention program on metabolic control of patients with type 2 diabetes. BMC Endocr Disord 17: 77 2017.

  • 34. Moghadam ST Najafi SS Yektatalab S. The Effect of Self-Care Education on Emotional Intelligence and HbA1c level in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Clinical Trial. Int J Community Based Nurs Midwifery 6(1): 39-46 2018.

Journal information
Impact Factor

CiteScore 2018: 0.19

SCImago Journal Rank (SJR) 2018: 0.128
Source Normalized Impact per Paper (SNIP) 2018: 0.229

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 187 147 7
PDF Downloads 125 100 5