We think of diabetes as a chronic disease of the blood. When the body doesn’t produce insulin from birth (Type 1) or does so inefficiently due to contributing factors (Type 2), the body struggles to control blood sugar levels. But increasingly, diabetes is being linked to mental health and in 2017, the American Diabetes Association made mental health a standard of diabetes care. Dr. Miguel Ariza, Medical Director of the Diabetes and Endocrine Center, discusses the impacts of mental health on managing this disease.
Unfortunately, what we’ve learned is depression and anxiety come hand in hand with diabetes. More than half of our patients with diabetes have anxiety or depression as well.
The state of the world right now can bring a lot of anxiety and feelings of uncertainty to patients. An additional concern is that diabetes is also a risk factor for more serious complications from COVID-19. Many have had to reassess whether to continue working at a job they are at or do activities they like to do. These safety concerns become significant challenges to managing their diabetes.
It can be one of the biggest challenges we face. Mental health conditions have become a barrier for patients to self-manage and work on their disease. We see it play out over and over again – patients lose their motivation to stay physically active and stick with their dietary needs. When patients lack a support system, it becomes even more of an issue.
When we see patients for a new visit, we screen for depression and inquire about anxiety and the patient’s living situation. We also ask what they think about their diagnosis and how they are coping. These kinds of questions are very important. Then we work with them and monitor whether there is an improvement in their blood sugars.
We have a multidisciplinary team at the center that includes physicians, diabetes nurse educators and nutritionists all in one place. Some of our staff have diabetes themselves and know what it is like to live with this disease. If a patient requires more resources, we now have a Chronic Disease Management Program we can refer them to. They will learn more about a patient’s support system and even send out a social worker to evaluate a patient’s needs and connect them with the resources they need.
From the very beginning we’ve been working to stay available to all of our patients. Initially it was by phone, but soon thereafter we started doing face to face appointments with all of the proper COVID-19 precautions so they could see us. And we are bringing back our support groups in a virtual way, because we know how important that can be for patients who may feel isolated or on their own.