The psychosocial burdens of living with diabetes

Aim: to better understand the prevalence of self-reported psychosocial burdens and the unmet needs identified by people with diabetes in relation to routine diabetes visits.Methods: an English language, online survey was distributed via social media, key stakeholder networks, charity and advocacy groups to adults with type 1 diabetes or type 2 diabetes. Survey items were designed by members of the FDA RESCUE Collaborative Community Governing Committee prior to pilot testing with potential participants. Descriptive statistical analyses were conducted; as well as thematic analyses on free text responses using NVivo v14.Results: 478 participants completed the survey. 373 (78%) had type 1 diabetes, 346 (73%) identified as a woman and 433 (91%) were white. Most participants had experienced self-reported (rather than diagnosed) anxiety and depression (n=323 and n=313 respectively), as well as fear of low blood sugars (n=294), low mood (n=290) and diabetes-related distress (n=257). 68% reported diabetes had negatively affected self-esteem and 62% to feelings of loneliness but 93% reported friends/family/work colleagues were supportive when needed. 272 (57%) reported their diabetes team had never raised the topic of mental health. The overwhelming majority stated the best thing their diabetes team could do to help was to simply ask about mental well-being; listen with empathy and without judgement; and practice skills to understand psychosocial issues in diabetes.Conclusion: integrating psychosocial discussions and support within routine healthcare visits is crucial to improve outcomes for people with diabetes. Such a biopsychosocial model of healthcare has long been advocated by regulatory bodies.