Living with a complex, chronic health condition like type 1 diabetes (T1D) is complicated, expensive, and burdensome. Most people live long, happy, healthy, and satisfying lives with T1D, yet there is a large body of evidence that mental health concerns and behavioral challenges are common, and interfere with self-management, quality of life, and health. At the same time, there are not enough professionals who have knowledge of the complex interplays between diabetes and psychosocial factors to meet the needs of the large and growing population of people with T1D, and their families.
To help address this gap, the Type 1 Diabetes Mental Health Workbook was created to provide a concise, practical resource for mental health clinicians and therapists to use in their care of young people with T1D. The workbook is divided into eight sections:
Overview of T1D
Language and communication about T1D
Challenges associated with a new T1D diagnosis
Approaches to addressing T1D self-management challenges
Emotions associated with T1D
Mood concerns and T1D
T1D-related worries and anxiety
Additional considerations
"Definitions", Type 1 Diabetes Mental Health Workbook: A Practical Resource for Providing Behavioral and Mental Health Support to Young People with Type 1 Diabetes, and Their Families
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Definitions
Acute complications: Short-term effects of out of range blood glucose, including hyperglycemia, hypoglycemia, diabetic ketoacidosis, seizure, and coma.
Automated insulin delivery system: Also known as “artificial pancreas,” “closed-loop,” or “hybrid closed-loop.” These systems include a connected insulin pump and continuous glucose monitor with a software algorithm that adjusts insulin delivery based on current and predicted glucose.
Basal and bolus insulin: Basal insulin is long-acting or intermediate insulin administered once a day to regulate glucose throughout the day. Bolus insulin is short- or rapid-acting insulin administered at meal-times to regulate glucose fluctuations with food intake or when glucose is too high. A basal–bolus insulin regimen is designed to mimic the functioning of a pancreas without T1D.
Blood glucose meter: Device used to measure current blood glucose using a droplet of blood from a fingerstick.
Continuous glucose monitor: Device worn on the body to measure interstitial glucose every 5 minutes. A sensor is positioned on the skin that includes a cannula (i.e., a tiny plastic tube penetrating the skin) that measures glucose, which is visible on a separate handheld display or smartphone app.
Diabetes distress: A common emotional response to the everyday burdens, challenges, and stressors related to living with and managing T1D. There are some similarities to depressive symptoms, but diabetes distress is related specifically to diabetes.
Diabetic ketoacidosis: Serious acute complication of hyperglycemia in which the body begins to burn fat and muscle for energy. Blood acids called ketones are produced and coma or death may occur.
Fear of hypoglycemia: Concern about the potential risk of low blood glucose level. Moderate amounts of fear may be adaptive and may lead to appropriate self-management behaviors; extremely high fear may interfere with functioning.
Glycemic variability: Increases and decreases in blood glucose outside the recommended range (usually 70–180 mg/dL).
Hemoglobin A1c (A1C): Blood test indicating average glucose during the past 2–3 months and a common marker of overall diabetes-related health. The American Diabetes Association A1C target for most people is <7.0%.
Hyperglycemia: Blood glucose above the target range (usually >180 mg/dL).
Hypoglycemia and severe hypoglycemia: Blood glucose below the target range (usually <70 mg/dL). Severe hypoglycemia is an urgent safety situation when the person with diabetes requires assistance from another person, often <54 mg/dL.
Insulin pump: Device worn on the body that administers insulin through a cannula that penetrates the skin. Some models communicate directly with glucose data from a continuous glucose monitor, see “Automated insulin delivery system.”
Long-term complications: Health consequences of diabetes across time, including problems with the heart, eyes, nerves, reproductive organs, and other health systems.
Time in range: Percent of time one’s glucose is in the target range (usually 70–180 mg/dL) throughout a specified period, calculated from continuous glucose monitor readings.
