We welcome the timely publication of the American Diabetes Association (ADA) Position Statement “Psychosocial Care for People With Diabetes” by Young-Hyman et al. (1). This document seeks to provide diabetes care providers with evidence-based guidelines for psychosocial assessment and care of persons with diabetes as well as their family members. We highlight a few comparisons between this statement (1) and India’s national recommendations on the psychosocial management of diabetes (2).
ADA supports the integration of psychosocial care in medical care and its universal provision to persons with diabetes. It views such care as an ongoing process. Assessment, monitoring, and addressal of such issues is encouraged at regular intervals and as required. The statement also highlights the importance of changes in disease course, treatment, or life circumstances as flags for psychosocial assessment and intervention. Specific focus is put on self-management, diabetes distress, fear of hypoglycemia, depression, anxiety disorders, disordered eating behavior, and serious mental illness. Life-course considerations are mentioned separately, with vulnerable age-groups and patient subsets getting special attention.
ADA describes preconception counseling as being necessary from puberty onward. This may cause discomfort in cultures that relate conception to marriage. Perhaps a more suitable term would be adolescent behavior counseling or sexual education.
The Indian guidelines use a reader-friendly structure, describing general issues, psychological assessment, and care. They discuss interventions such as coping and counseling therapy, folk dance therapy, and yoga. However, diabetes distress, fear of hypoglycemia, and needs of older persons are not dealt with separately. The Indian document notes the challenges faced by young persons with diabetes in getting married and highlights gender-based issues as well. The Indian guidelines have been followed up with statements on psychosocial care of women during pregnancy and management in northeastern India, an area with unique demographic, sociocultural, and geographic characteristics (3,4).
Neither document discusses drug addiction as a psychosocial aspect of diabetes care, nor do they address compassion fatigue of caregivers and diabetes care professionals. Together, the two documents provide a comprehensive overview of relevant psychosocial screening, diagnosis, and management for people with diabetes, which should meet the needs of diabetes care professionals across the world.
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Acknowledgments. The authors thank Arnav Kalra (All India Institute of Medical Sciences, Rishikesh, India) for help in the preparation of this manuscript.
Duality of Interest. No potential conflicts of interest relevant to this article were reported.
