Type 2 diabetes mellitus (T2DM) is a critical health problem in the United States and other developed countries. According to Massey, Feig, Duque-Serrano, and Huffman (2017), psychological distress and depression are frequent in patients with T2DM. Recent studies show that 13.8% of patients with diabetes are likely to have depression, while 44.6% of patients have diabetes-related distress (Chew, Shariff-Ghazali, & Fernandez, 2014). Therefore, addressing the psychological aspect in T2DM patients is a crucial part of treatment.
History and Statistics
It has become habitual for scientists to associate the type 2 diabetes diagnosis with an increasing contingency of developing mental disorders, such as depression and psychological distress. Depression, for example, is two to three times more frequent in T2DM patients than in the general population (Tareen, & Tareen, 2017). Although this time-honored statement may be conventional, recent studies show that relationships between diabetes and psychological well-being is bidirectional. Emerging evidence suggests that emotional distress, apathy, and depression can be risk factors for developing T2DM. People with pre-existing depression, for example, have a 60% risk of developing diabetes, while having T2DM implies much smaller possibilities of developing such symptoms (Tareen, & Tareen, 2017). Moreover, the results of the study by Massey, Feig, Duque-Serrano, and Huffman (2017) show that the increase in the odds of psychological distress associated with T2DM diagnosis was only modest and statistically insignificant.
The explanation of such a shift in views may be associated with the introduction of a clearer discretion between symptoms. For instance, recent studies show that emotional disorders may be caused not by diabetes, but by obesity, noncompliance, or psychotropic medications (Tareen, & Tareen, 2017). Besides, some of the T2DM and Hypoglycemia symptoms, such as irritability, fatigue, and shakiness, are often taken for psychiatric symptoms (Tareen, & Tareen, 2017). In short, the relationship between T2DM and psychiatric disorders has shifted towards a deeper understanding of cause and consequence, thus promoting hope for better medical outcomes.
Significance to Health Issues
Type 2 diabetes is greatly influenced by lifestyle factors, including nutrition and smoking, the patient’s weight, and his or her pre-existing psychological condition. Hence, the American Diabetes Association [ADA] (2015) states that patient education, healthy lifestyle, and smoking cessation are at the foundation of T2DM prevention and management. Moreover, Massey et al. state, that “positive psychological characteristics-optimism, positive affect, gratitude, and related constructs-may also play an important role in medical outcomes” (para. 2). Positive psychosocial factors facilitate chronic diabetes care and relate to self-care behavior, such as treatment adherence and frequency of blood glucose monitoring (Chew et al., 2014). Sound emotional health is also linked with better health-related life quality and subjective health (Feng & Astell-Burt 2017). Besides, Chew et al. (2014) underlines the connection between depressive symptoms in patients with diabetes and systemic inflammatory markers. In brief, addressing psychological health while treating T2DM can notably influence patients’ health issues.
Role and Relevance of Nursing Practice
The primary treatment for T2DM is self-management and anti-diabetes medications. As examined earlier, patients with psychological issues often fail in shifting their lifestyle towards self-control. With patients treated in primary care, “nurse communication plays a pivotal role in supporting patient health” (Mulder, Lokhorst, Rutten, & van Woerkum, 2014, p. 1). Nurse consultations aim to help patients through diabetes education and emotional support. On the one hand, the consultations can influence patients’ health by providing the specific examples of changes in lifestyle that lead to improvements. On the other hand, nurses can directly affect patients’ health by validating the inmates’ perspective or expressing empathy (Mulder et al., 2014).
While the importance of a nurse is obvious, some significant problems in practice may emerge while focusing on the psychological aspects of T2DM. Most nurses feel a lack of authority, as patients seldom view the nursing staff as a trustworthy and valuable source of information. Besides, nurses rarely have adequate communication skills to address the mental condition of a patient (Mulder et al., 2014). Although this may be true, it is common knowledge that patients start a conversation with nurses easier than with therapists. In summary, nurses are decisive facilitators of healthcare provision in treating psychological aspects of type 2 diabetes.
T2DM patients increase in numbers daily, thus demanding the healthcare system to approach the issue from all angles. On this basis, addressing psychological health of diabetes patients has become an essential part of treatment, as ADA (2015) shows. Chew et al. (2014) states that “positive emotional health may sustain long-term coping efforts and protect patients from the negative consequences of prolonged emotional disorders” (p. 804). The paper shows that health care providers of all levels must attend to the subject of improving patients’ mental health while treating T2DM. Especially this statement concerns nurses as medical care front liners.
American Diabetes Association (2015). Standards of medical care in diabetes — 2015 abridged for primary care providers. Clinical Diabetes, 33(2), 97-111.
Chew, B., Shariff-Ghazali, S., & Fernandez, A. (2014). Psychological aspects of diabetes care: Effecting behavioral change in patients. World Journal of Diabetes, 5(6), 796.
Feng, X., & Astell-Burt, T. (2017). Impact of a type 2 diabetes diagnosis on mental health, quality of life, and social contacts: A longitudinal study. BMJ Open Diabetes Research & Care, 5(1), 1-5.
Mulder, B., Lokhorst, A., Rutten, G., & van Woerkum, C. (2014). Effective nurse communication with type 2 diabetes patients. Western Journal of Nursing Research, 37(8), 1100-1131.
Massey, C., Feig, E., Duque-Serrano, L., & Huffman, J. (2017). Psychological well-being and type 2 diabetes. Current Research in Diabetes and Obesity Journal, 4(4), 1-6.
Tareen, R., & Tareen, K. (2017). Psychosocial aspects of diabetes management: Dilemma of diabetes distress. Translational Pediatrics, 6(4), 383-396.