People with diabetes hit hard by pandemic

This year, National Diabetes Week (12–18 July) will focus on supporting the emotional and mental health of people living with diabetes, and will draw attention to gaps in diabetes services and care.

Coinciding with the event, Diabetes Australia has launched its Heads Up on Diabetes campaign, which focuses on the mental and emotional health impact of living with diabetes and encourages people to talk about it and access support if they need it.

People with diabetes have been hit hard by the COVID-19 pandemic — physically and mentally. In addition to disruptions to diabetes services and a higher risk of serious COVID-19 related illness, 40% of people with diabetes report that COVID-19 has had a negative impact on their mental or emotional health.

Releasing results of a national survey, Diabetes Australia found that people with diabetes have particular needs when it comes to mental and emotional health:

• Almost half of all people with diabetes (47%) have experienced a mental health challenge because of their diabetes in the last 12 months. This was higher (over 65%) for people with type 1 diabetes and women with gestational diabetes.
• Younger people (<40 years) are much more likely to have mental health challenges — there are more than 124,000 Australians with diabetes who are under the age of 40.
• Although 40% of people with diabetes have spoken to a health professional about their mental health, more than 80% said they had not been offered professional psychological support, and more than 25% were not able to access mental health support when they needed it.
• More than one in three people with diabetes (37%) say they feel burned out by the constant effort required to manage diabetes.
• More than one in four people (26%) said other people’s attitudes and stereotypes about diabetes negatively impacted their mental health.
   

Diabetes Australia CEO Professor Greg Johnson said it was critical that health professionals, people with diabetes and the broader community recognise the seriousness of the mental and emotional health impact of living with diabetes.

“Diabetes is absolutely relentless. Day in, day out, 365 days a year,” Professor Johnson said.

“People have to keep track of many daily tasks — medicines, blood-glucose monitoring, and the numerous ongoing health checks that are required.

“The distress and worry about the long-term impact is real. Two-thirds of people with diabetes are worried about their long-term risk of developing serious diabetes-related complications like losing limbs, eyesight, experiencing kidney failure or heart failure.”

Professor Johnson said the survey revealed people with diabetes need more access to specialised psychological support to help them manage the mental health side of life with diabetes.

“Diabetes is both a physical health and mental health challenge. This survey found significant gaps in people’s ability to access mental health support,” he said.

“Mental and emotional health needs to become a routine part of diabetes care, just like seeing a podiatrist or optometrist.

“The mental health challenges associated with living with diabetes can make it harder for people to manage their physical health and increase their risk of developing serious diabetes-related complications.”

Professor Jane Speight, Foundation Director of the Australian Centre for Behavioural Research in Diabetes, said the evidence around the mental and emotional health impact of living with diabetes had been growing over the past 25 years — and now is the time for change.

“We need to change the mindset that says diabetes is ‘just’ a physical condition. It’s not. The mental and emotional health impact of living with diabetes can be massive,” Professor Speight said.

“It can be a combination of the day-to-day challenges of managing the condition, the anxiety and worry caused by the risk of serious health complications, and the accumulation of the impact of other people’s stereotypes, judgement and stigma.

“We need health systems and health policymakers to better consider the mental health aspect of living with diabetes to ensure people can access specialised mental health care and support when they need it.

“All health professionals involved with diabetes need to take action by learning more about the mental health impact of diabetes and developing strategies to ensure that people who need support can access it.”

A tale of two pandemics

Honorary President of the International Diabetes Federation and Professor of Diabetes at Monash University Paul Zimmet said diabetes and COVID-19 are two global pandemics in collision, which is very dangerous for people with diabetes.

COVID-19 infection can reveal previously undetected diabetes in people who actually have never had symptoms and can cause significant problems in the treatment of a person with COVID-19 complications.

“During this COVID-19 pandemic, it is vital that people with diabetes ensure very good control of their blood sugar levels though appropriate nutrition, exercise if possible, to take their regular medications and continue to be in contact with their diabetes specialist and general practitioner,” Professor Zimmet said.

“They should also follow all of the government recommendations, including good hygiene and self-distancing. In this way, they can reduce their higher risk of infection by this cunning and catastrophic virus.

“COVID-19 has only been with us for about six months so we do not yet know for certain whether people with diabetes are more susceptible to be infected by the virus. It is quite possible that they are and we do know that the complications of COVID-19 infection, such as dangerous pneumonia and other organ damage, including heart and brain, are extremely serious for people with diabetes.

“They may be life-threatening. This applies especially in older people with type 2 diabetes, obesity and heart conditions,” Professor Zimmet said.

Image credit: ©stock.adobe.com/au/Mediteraneo