Psychological issues

Diabetes healthcare providers are no strangers to the self-management model. Indeed, it could be said that diabetes is the field in which the self-management model has been most thoroughly developed and implemented. The marriage of expert clinical care with self-management by the individual is an ideal union and an increasingly common objective. It is an excellent goal – one that is achievable by many. Yet a number of systematic barriers to self-management exists.

From time to time, family doctor and chief medical officer Alan Glaseroff interviews panels of people with diabetes in front of an audience of other people with diabetes, medical professionals, diabetes educators and clinical teams. The panel members are people who, having successfully overcome obstacles which at first caused them to struggle with their condition, are willing to share their stories.

Healthcare implies sound knowledge in the field of biomedicine, underpinned by evidence-based medicine. There is another fundamental dimension: the healthcare provider-patient relationship. Balint studied the gap between the professional identity of doctors and the reality of patients – an ocean of unspoken messages separates their worlds. The further dimension is that of therapeutic education, the objective of which is to help people to become more autonomous. In these three aspects of healthcare, the relationship between patients and doctors is never even.

There are various ways to improve people’s capacity to cope with the psychological burden of a chronic condition. A recent programme based on self-expression through painting demonstrated a way of discovering a person’s potential for development and self-efficacy. This report describes the structure and process of a painting workshop programme for people affected by a chronic condition. Attending one or several painting workshops, the participants used the art material to express and give shape to their inner suffering associated with their condition.

In the USA, approximately 24 million people have diabetes; more than half are women, and projections to 2050 suggest that women of all ages will continue to represent more than half of all cases. A growing concern  for  women with diabetes is the increased risk to many of developing major depression. The results from a recent meta-analysis of 42 studies showed that women with diabetes have a higher prevalence of depression (28%) than men with diabetes (18%).

Xiaoping, a 15-year-old girl living in a rural region of china, was diagnosed with type 1 diabetes in october 2007. since then, her life has undergone a series of dramatic changes.

People  with  diabetes  face  a  range  of challenges. Having the condition affects all areas of life; a number of psychological and emotional factors are involved. Recently, one of the authors of this article, Robin Wynyard, was diagnosed with type 2 diabetes. The shock of being diagnosed provoked in him and his partner, Sue Shea, negative feelings that included fear, anxiety and uncertainty – a common emotional response which often goes unreported in the related literature.

Obesity has become a pandemic, affecting adults and children around the world.  Considerable medical, scientific and lifestyle-related knowledge and resources are being channelled into the identification of strategies to combat this major public health problem. Despite these multidisciplinary efforts, however, little attention has been paid to the damaging social and psychological consequences of obesity.

Type 2 diabetes significantly increases a person’s risk of developing multiple health complications, but the risk of these complications can be significantly reduced with modern, comprehensive diabetes care. This care is inherently complex because of its use of multiple medications in conjunction with lifestyle changes in diet, exercise, and blood glucose self-monitoring.

President's editorial