Cognitive Behavioral Therapy for Adherence and Depression in Diabetes

Abstract

Approximately 14.3 % of the nationally representative population of noninstimtionalized adults was estimated to have diabetes in 2012, and slightly over one-third were unaware of their diagnosis. Strikingly, an additional 38 % were estimated to have significantly elevated blood sugars (glucose), or prediabetes, placing them at risk for the development of type 2 diabetes. Too few rigorous treatment studies are available for anxiety, eating disorders or severe mental illness to offer specific recommendations for applications in patients with diabetes. In clinical practice, clinicians should consider the context of diabetes and its management when evaluating and treating psychological conditions in individuals with diabetes. For example, patients with diabetes may experience significant anxiety related to insulin injections or may keep blood glucose levels high due to excessive fear and avoidance of hypoglycemia. Treatment approaches to psychopathology in diabetes should be sensitive to the burdens of illness and treatment and to the chronically stressful nature of diabetes self-management. A more detailed review of the wider treatment literature is available elsewhere. Here, we focus on the treatment of depression and emotional distress in diabetes, two of the most common psychological issues in patients with diabetes. Clinicians should also be aware that individuals who do not meet the diagnostic threshold for major depressive disorder but do experience symptoms of significant emotional distress are also at risk for poorer self-care, glucose control, and health outcomes; thus, subclinical symptoms may warrant treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved)