No worries, no impact? A systematic review of emotional, cognitive, and behavioural responses to the diagnosis of type 2 diabetes.

Previous research suggests that patients with type 2 diabetes quickly adjust to their diagnosis, but most studies tend to focus on emotional outcomes. This systematic review also examines patients' cognitive and behavioural responses in the first year after diagnosis, based on empirical studies published between 1993 and 2008. A total of 24 studies are presented in order from most to least rigorous design. A further distinction is made between being diagnosed in the context of a screening programme and other forms of diagnoses. This review confirms that the diagnosis of type 2 diabetes has limited long-term emotional impact, if at all, regardless of how patients are detected. Examination of cognitive and behavioural responses indicate that most patients underestimate the seriousness of their diabetes, overestimate their ability to control it and show limited engagement in the management of their disease. The results also indicate considerable variations in adjustment to the illness. These are related to symptom experience, prior knowledge, and information provision and treatment. Overall, this review shows that a lack of emotional distress does not necessarily indicate a successful adjustment but may instead reflect patients' tendency to avoid dealing with and managing their diabetes until the first signs and symptoms appear, potentially undermining the effectiveness of early detection and treatment. (aut. ref.