Addressing diabetes distress in clinical care: a practical guide

Addressing the emotional side of diabetes and its management has received considerable attention in recent years. At the centre of most of these efforts is the concept of ‘diabetes distress', a generic term that captures the primary sources and intensity of emotional distress associated with diabetes and its management over time. As interest in diabetes distress has grown, however, it has been difficult to integrate and translate the various strands of clinical research in a manner that can guide diabetes distress intervention efforts in the real world of clinical care. The aim of this paper is to fill this gap by outlining practical strategies for intervention in clinical settings and to assist diabetes healthcare professionals in thinking through how diabetes distress might be addressed practically in their clinics. To address these goals, this review is divided into five sections: a definition of diabetes distress, ways diabetes distress can be assessed and monitored, information about diabetes distress for use in intervention planning, topics to be considered for inclusion in diabetes distress interventions, and alternatives for where in the care process a diabetes distress intervention might be considered. We focus on diabetes distress experienced by adults with both Type 1 and Type 2 diabetes. What's new? As interest in diabetes distress has grown it has been difficult to integrate and translate the various strands of clinical research in a manner that can guide diabetes distress intervention efforts in the real world of clinical care. We outline practical strategies for intervention in clinical settings to assist diabetes healthcare professionals in thinking through how diabetes distress might be addressed practically in their clinics: programmes for highly distressed individuals; programmes centred around diabetes‐specific events, including information about distress to programmes of diabetes education; and incorporating distress content into all clinical contacts. We also provide a five‐step programme on distress content for use in clinical settings: assess distress regularly and systematically, focus on feelings and expectations, provide a new perspective, plan and follow‐up.