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Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies
  1. Emma Berry1,
  2. Sam Lockhart2,
  3. Mark Davies3,
  4. John R Lindsay4,
  5. Martin Dempster1
  1. 1School of Psychology, Queen's University Belfast, Belfast, UK
  2. 2School of Medicine, Dentistry and Biological Science, Queen's University Belfast, Belfast, UK
  3. 3Department of Clinical Psychology, Belfast City Hospital, Belfast, UK
  4. 4Department of Diabetes and Endocrinology, Mater Infirmorum Hospital, Belfast, UK
  1. Correspondence to Sam Lockhart, School of Medicine, Dentistry and Biological Science, Queen's University Belfast, Health Sciences Building, 97 Lisburn Road, Belfast BT9 7BL, UK; slockhart05{at}


Diabetes distress is a rational emotional response to the threat of a life-changing illness. Distinct from depression, it is conceptually rooted in the demands of diabetes management and is a product of emotional adjustment. Diabetes distress has been found to be significantly associated with glycated haemoglobin (HbA1c) level and the likelihood of an individual adopting self-care behaviours. The lack of perceived support from family, friends and healthcare professionals significantly contributes to elevated diabetes distress, and this issue tends to be overlooked when designing interventions. Pioneering large-scale research, DAWN2, gives voices to the families of those with diabetes and reaffirms the need to consider psychosocial factors in routine diabetes care. Structured diabetes education programmes are the most widely used in helping individuals cope with diabetes, but they tend not to include the psychological or interpersonal aspects of diabetes management in their curricula. The need for health practitioners, irrespective of background, to demonstrate an understanding of diabetes distress and to actively engage in discussion with individuals struggling to cope with diabetes is emphasised.

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