Diabetes is a chronic condition characterized by high blood glucose (BG) caused by the body’s inability to produce (type 1) or effectively use (type 2) insulin.1 As of 2021, there are 537 million adults living with diabetes worldwide, and this number is predicted to rise to 783 million by 2045.2,3 This means that there will be an increasing number of people who will experience a significant disease burden throughout their life. With this in mind, to better support people living with diabetes, we need to better understand their true lived experiences…

A 24/7 job with no end date

Diabetes management is complex and demands a great deal of mental focus and energy; it requires a comprehensive understanding of the condition and one’s own physiology, healthy coping strategies, and skills in problem-solving. Depending on the type of diabetes and if there is a need for risk management, diabetes management can involve several daily activities including monitoring BG, injecting insulin, taking oral medications, regular physical activity, and healthy eating.

“Patient empowerment is critical. People with diabetes need to become experts in controlling their motivations, behaviors, and social environment to help them achieve their goals. From my experience, this takes a lot of effort, day after day, and managing diabetes is a commitment you make daily to do the best job you can to control your BG. This is exhausting. I’d love to have a day off from having diabetes.” Shanida Nataraja, Senior Director at AXON

Treatment guidelines from the American Diabetes Association (ADA) provide healthcare professionals (HCPs) with recommendations on pharmacological and lifestyle strategies, with the goal of helping patients to achieve optimal glycemic control.4 These global treatment guidelines primarily focus on how to reduce glycated hemoglobin (HbA1c) and increase the proportion of time spent with BG levels in the target range.4 Although achieving optimal glycemic control is pivotal for reducing the risk of diabetes-related complications and ensuring physical well-being, diabetes management and the unconscious pressure to achieve strict numerical goals may negatively impact emotional and social well-being.

“I have lived with T1D for over 25 years, and I still think about my condition 24/7. Despite technological advancements that can support my diabetes management, I must make several decisions every day to ensure that my BG is constantly near-perfect. I sometimes become overwhelmed by the huge responsibility T1D imposes and how lonely I am with these thoughts. Ultimately, the way I manage my diabetes today will affect my risk of future complications.” Louise Magnusson, Medical Writer at AXON

A large proportion of people with diabetes report being afraid of developing diabetes-related complications that will affect their well-being, as well as facing difficulties in maintaining a positive outlook in regards to their condition, and experiencing diabetes distress.5 Greater diabetes distress is associated with suboptimal diabetes management, higher HbA1c, and impaired quality of life.6 However, optimal glucose control does not indicate absence of or low diabetes distress, because intensive, potentially unsustainable strategies may be needed to achieve this. Therefore, with over one-third of people with diabetes experience diabetes distress,5 we must acknowledge that reduced mental well-being is a considerable unmet need, and share the responsibly among the whole diabetes community.

Are we doing enough to increase well-being?

Although recent global treatment guidelines provide recommendations related to psychosocial care,7 diabetes distress can still pass unnoticed during patient–HCP interactions. Implementation of recommendations is lacking, and common barriers for HCPs include lack of skills, confidence, time, and access to practical resources.6 Most treatment guidelines fail to provide guidance on how to incorporate psychosocial monitoring in clinical practice.6 So surely there is an opportunity to do more…

The ADA has published a ‘Diabetes and Emotional Health’ Workbook, which provides in-depth recommendations on how to communicate and engage with patients about their well-being, and also includes case reports and tools to incorporate into clinical practice.6 The theme for the 2024 World Diabetes Day on 14 November (organized by the International Diabetes Federation) is ‘Diabetes and well-being’, providing a platform for national diabetes associations, people with diabetes, and other volunteers to help increase awareness by, for example, online courses, work events, and school activities.5

“The ADA Workbook highlights the burden of managing diabetes that is placed on the patient, and the importance of cultivating self-control and resilience to be able to control it effectively. I had to learn by trial and error what worked for me. I had to develop my own coping strategies. Effective management stems from a partnership between physician and patient. Whether this type of partnership is feasible in resource-stretched times is another question.” Shanida Nataraja, Senior Director at AXON

Looking ahead: a collective commitment

Increased public awareness about diabetes can reduce stigma and promote understanding, while empowering people with diabetes to manage their condition effectively and advocate for their needs. The above-mentioned initiatives will highlight that comprehensive diabetes care should integrate both physical and emotional support. We all have a pivotal role to play to improve the well-being of people living with diabetes.

Medical communications can bridge the gap between complex medical information and the individuals who need it the most. As well as the medical benefits, it is important to communicate the emotional benefits of novel treatments, which provide an additional layer of support for people with diabetes that extends beyond the numbers on a BG monitor. With our collective experiences and awareness of the disease burden, we are committed to transforming the perfectives of HCPs and patients; our goal is to emphasize the positive impacts that novel treatments can have on the emotional and social well-being of people with diabetes throughout their everyday lives.

We are ready, are you?

REFERENCES

  1. National Institute of Diabetes and Digestive and Kidney Diseases. What is diabetes? (2023). Available from: https://www.niddk.nih.gov/heal.... Accessed November 2024
  2. Sun H et al. Diabetes Res Clin Pract 2022:183:109119
  3. International Diabetes Federation. IDF Diabetes Atlas 10th edition (2021). Available from: https://diabetesatlas.org/atla.... Accessed November 2024
  4. American Diabetes Association Professional Practice Committee. Diabetes Care 2024;47(Supplement_1):S1–S321
  5. International Diabetes Federation. Let’s talk about well-being for a better diabetes life (2024). Available from: https://worlddiabetesday.org/. Accessed November 2024
  6. Hendrieckx C, Halliday JA, Beeney LJ, Speight J. Diabetes and emotional health: a practical guide for health professionals supporting adults with type 1 or type 2 diabetes. Arlington, VA, USA: American Diabetes Association, 2021, 3rd edition. Available from: https://professional.diabetes.org/professional-development/behavioral-mental-health/MentalHealthWorkbook
  7. American Diabetes Association Professional Practice Committee. Diabetes Care 2024;47(Supplement_1):S77–S110