Healthcare professionals should routinely discuss the emotional impact of diabetes with patients, according to a clinical practice guideline developed by the European Association for the Study of Diabetes (EASD).

Published by Diabetologia, the guidance paper calls for regular assessment and monitoring of diabetes distress – feelings of frustration, defeat or being overwhelmed by managing the condition – in adults with type 1 and type 2 diabetes, with personalised support where needed.

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The guideline draws on findings from the D-Stress study, co-funded by Diabetes UK and the National Institute for Health and Care Research (NIHR), which is developing and testing a UK programme to treat diabetes distress.

Key recommendations for healthcare professionals include:

talking about the emotional impact of diabetes during routine appointments;
using trusted assessment tools to consistently identify diabetes distress;
monitoring diabetes distress over time;
working together with people experiencing diabetes distress to make personalised support plans; and
offering evidence-based support to help manage diabetes distress.

For people with type 1 diabetes, research showed psychological interventions and diabetes technology, including continuous glucose monitoring and hybrid closed loop systems, helped to reduce distress.

For those with type 2 diabetes, psychological support and education were found to be beneficial.

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However, the guideline notes the absence of a single solution suitable for everyone, and recommends that support is tailored to each patient’s individual needs and circumstances.

Diabetes UK observed that diabetes distress is not currently routinely assessed during diabetes appointments, despite people with the condition reporting that its emotional impact can be as challenging as its physical effects.

It highlighted that, according to the guidance, checking how people are coping emotionally should be ‘a core part of diabetes care, not something to discuss only when problems appear’.

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Professor Chantal Mathieu, EASD president, said: ‘Despite huge advances in therapies and technologies, the emotional burden of diabetes has not diminished – and for many, it has increased.

‘This guideline recognises that reality, reminding us that good diabetes care must address both glucose levels and the lived experience of managing the condition.’