All entries for Thursday 31 March 2011

March 31, 2011

The emotional burden of diabetes and its impact on healthcare provision

Diabetes UK is holding its annual professional conference at the Internatinal Convention Centre, London ExCeL this week and Warwick Medical School has a stand in Hall A18.

Hands holding syringe of insulinThe emotional burden of diabetes is often greatly under-diagnosed and can manifest itself as depression, eating disorders, anxiety, needle phobia and severe mental health conditions. These negatively impact on self-care which leads to poorer glycaemic control and long term complications for the patient. The cost of diabetes care for someone with severe depression is 251 per cent higher than the standard cost.

Based at University Hospital Coventry, the WISDEM clinical service has developed the Diabetes Listener Service. The service, lead by Dr Jackie Sturt from Warwick Medical School, provides psychological care and up-skilling for diabetes clinicians who have no specialist psychological care training. Jackie is supported by the Trust’s Clinical Psychology service.

The Diabetes Listener Service offers up to six 45 minute appointments for people who are struggling to cope with their diabetes. These individuals are most often identified by other team members in their routine clinical consultations and a referral made if appropriate. People with diabetes experiencing high distress levels are also identified through screening using the PAID scale in specialist clinics such as the Acute Diabetic Foot service.

In the first 6 months of this service, 135 patients were screened for diabetes-specific distress using the PAID scale. On the PAID scale a normal/healthy outpatients score would be 20-33. A score of 40 to 50 indicates sub-clinical depression and over 50 indicates a diagnosis of clinical depression. From our screened population a quarter of patients scored over 50 indicating severe diabetes-specific distress and probably clinical depression.

In the same period, 29 people were referred to the Diabetes Listener Service of which 15 (over half the referred population) scored 50 and above only eight were found to be in the emotionally healthy range. This data indicates that the WISDEM diabetes clinicians demonstrate skill in identifying emotional distress in their patients although by the time the patient is referred, the distress levels are very high. So what’s needed may be annual screening which could enable us to identify and respond to this distress at an earlier stage.

Evaluation of the Diabetes Listener Service continues and we hope to present the findings at Diabetes UK APC 2012.

Dr Jackie Sturt is Associate Professor in Social and Behavioural Sciences at Warwick Medical School Warwick Institute for Diabetes, Endocrinology and Metabolism

The Warwickshire Institute for Diabetes, Endocrinology and Metabolism (WISDEM) – a specialist Centre providing treatment and support for the more complex cases of diabetes, endocrine and metabolic conditions was officially opened in January 2007 in the East Wing of University Hospital, Coventry.


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