摘要
It has long been accepted that psychological factors adversely influence efforts to optimise glycaemic control.These are often unrecognised in terms of clinical assessment and therefore under reported.This essay presents an introduction to psychological issues that interact with psychiatric co-morbidities and diabetesspecific distress,and a case scenario illustrating the interconnectedness of presenting problems and themes.In the way that we cannot separate carbohydrate counting,blood glucose monitoring and insulin doseadjustment in the understanding of a presenting problem such as poor control,so we cannot separate the concurrent thoughts,feelings,and behaviours.Each of these emotional aspects are self-managed either through avoidance,or by delayed disclosure and are frequently associated with poor health outcomes.There is a requirement for the healthcare team to be sensitised to these issues and to develop styles of communication that are empathic,reflective and non judgemental.A brief outline of evidence-based psychotherapy treatments is given.
It has long been accepted that psychological factorsadversely influence efforts to optimise glycaemic control.These are often unrecognised in terms of clinicalassessment and therefore under reported. This essaypresents an introduction to psychological issues thatinteract with psychiatric co-morbidities and diabetesspecificdistress, and a case scenario illustrating theinterconnectedness of presenting problems and themes.In the way that we cannot separate carbohydratecounting, blood glucose monitoring and insulin doseadjustment in the understanding of a presentingproblem such as poor control, so we cannot separatethe concurrent thoughts, feelings, and behaviours.Each of these emotional aspects are self-managedeither through avoidance, or by delayed disclosure andare frequently associated with poor health outcomes.There is a requirement for the healthcare team tobe sensitised to these issues and to develop stylesof communication that are empathic, reflective andnon judgemental. A brief outline of evidence-basedpsychotherapy treatments is given.
