Improving Psychosocial Care for People with Diabetic Neuropathy

What is it about?

Diabetic neuropathy (DN) can severely impact an individual's psychological functioning and quality of life. Depression in DN patients can worsen self-care and increase the risk of adverse outcomes, yet it often goes undetected and untreated. There is a lack of information in American Diabetes Association guidelines regarding DN-specific assessments. A few psychological interventions have shown effectiveness in reducing painful DN's impact. The psychosocial impact of DN includes depression, anxiety, poor sleep quality, and specific problems like fear of falling and fear of amputation. Risk factors for DN include biological, behavioral, and psychosocial factors. Racism is a key social determinant of health that contributes to health inequities. Painful DN affects up to 30% of individuals with DN and has a significant impact on quality of life. Psychological factors like pain catastrophizing and psychological flexibility can impact individuals' adaptation to painful DN. Sleep quality is crucial for successful DN management. DN increases the risk of incident psychiatric disorders.

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Why is it important?

Diabetic neuropathy (DN) is a common and burdensome complication of diabetes that can significantly impact psychological functioning and quality of life. Depression in individuals with DN can hamper self-care and increase the risk of adverse outcomes, yet it often remains undetected and untreated. This research highlights the importance of addressing the psychological factors and psychosocial care for individuals with DN, as it can have a significant impact on their overall health and well-being. Key Takeaways: 1. Diabetic neuropathy (DN) is a common and burdensome complication of diabetes that can markedly impair psychological functioning and quality of life. 2. Depression in individuals with DN can hamper self-care and increase the risk of adverse outcomes, yet it often remains undetected and untreated. 3. American Diabetes Association guidelines include recommendations for use of self-report measures in diabetes care but do not include information regarding DN-specific assessments (e.g., pain severity and pain interference, postural instability, or DN-specific quality of life). 4. A few psychological interventions have been tested in DN; results suggest that acceptance and commitment therapy and cognitive behavioral therapy are effective for reducing the impact of painful DN. 5. Areas such as DN-postural instability deserve more attention. 6. Risk of DN reflects biological, behavioral, and psychosocial factors, including social determinants of health such as race/ethnicity disparities, socioeconomic status, education, and insurance gaps. 7. Psychological factors and psychosocial care for individuals with diabetic neuropathy are important but overlooked areas that require attention.