Diabetes and the psychiatrist: optimising patient care

Diabetes is a global health emergency. It is estimated that up to 463 million adults worldwide between 20 and 79 years of age have diabetes (9.3% of people in this age range); this is expected to rise to 578.4 million by 2030 and 700.2 million by 2045 (Saeedi et al, 2019).

Diabetes is both a cause of and a result of mental health disorders:

• Depression, anxiety disorders, disordered eating behaviour and serious mental illness are prevalent among patients with diabetes.
  
  
• Psychiatric and psychological factors may present barriers to effective self-management, which makes it difficult for people with certain conditions such as depression, psychosis and eating disorders to attain optimal glycaemic control and to perform diabetes care.
  
  
• Depression, for example, is increasingly being regarded as a risk factor for morbidity in diabetes, likely in part due to the impact of reduced motivation on the active self-management required for good diabetes control.

For people living with these comorbidities, coordinating the management of the condition with the diabetes may improve both their mental health outcomes and their glycaemic control.

In this module we will recap on the evidence-based treatment of diabetes and the importance of optimising glycaemic control, as well as the role of the management of comorbid mental disorders (depression, psychosis and eating disorders) in helping patients to attain this.