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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Entries Tagged as 'Psychosocial'

The Stigma of Having Type 2 Diabetes

August 28th, 2016 · Comments Off

Many of us who have Type 2 diabetes feel the stigma of our condition. For most of the 22 years that I have known I had it, I was reluctant to tell anyone that I have diabetes. Until a few years ago, I would describe myself, if asked, as a medical writer, even though my full-time work is writing about diabetes and advocating for people who have it.

Likewise, only recently have researchers begun the scientific study of the stigma of diabetes and the physical and mental effects that it has on us. Until now, quantitative research has been limited by the absence of reliable and validated measures of perceived and experienced diabetes stigma.

Serious study of diabetes stigma is just beginning

Compared to what we know about the stigma affecting people with other chronic conditions, the diabetes evidence is sparse. We know much more about how people with HIV/AIDS, obesity, and epilepsy are stigmatized. I know directly about the stigma of having epilepsy because my mother was so ashamed of having it that she never told her children.

Now, researchers can use the new Diabetes Stigma Assessment Scales to systematically study the effects of stigma on people with Type 1 or with Type 2 diabetes. These scales were reported in a late-breaking poster presented at the American Diabetes Association’s convention of about 16,000 professionals in New Orleans this June. I represented Health Central there.

We do have some quantitative research about diabetes stigma. I also found narrative reviews and reports of personal experiences, including job discrimination, restricted opportunities in life, and unfair judgments.

Three-fourths feel judged

A survey just reported that 76 percent of adults with diabetes have felt judged by family members or friends for how they manage their diabetes. And 54 percent of them frequently feel judged. I obtained a copy of this survey of 500 adults with diabetes from a representative of Roche, which commissioned it from Wakefield Research.

In 2013, the researchers who developed the new assessment scales reported what they think was the first qualitative study of diabetes stigma. Noting then that they needed more research in how to measure stigma, they published their findings of this small study in the professional journal BMJ Open. Their key conclusion was that of the 25 adults with Type 2 diabetes in the study, 84 percent reported that they felt their condition was stigmatized or they reported evidence of stigmatization.

The things we need to do can lead to stigma

When someone has Type 2 diabetes, it’s not immediately obvious, the study points out. But needing to take diabetes drugs or insulin injections, checking blood glucose levels, and following a different diet may be conspicuous. When people inject insulin in public, others may assume they are drug addicts. The symptoms of low blood glucose can include confusion and dizziness, which can be mistaken for drunkenness. Any of these activities can lead to diabetes stigma.

But what do researchers mean by stigma? The research often quotes what Professors Mitchell Weis and Jayashree Ramakrishna published a decade ago in the influential journal The Lancet:

“A social process or related personal experience characterised by exclusion, rejection, blame, or devaluation that results from experience or reasonable anticipation of an adverse social judgment about a person or group identified with a particular health problem. The judgment is medically unwarranted.”

Stigma can lead to poor self-management

The most comprehensive narrative review that I discovered was a 2013 study in the journal Patient, “Social Stigma in Diabetes.” It concluded that the stigma “has a significant impact on psychological well-being.” But that is hardly all. Depression often can lead us to ignoring the diabetes with the inevitable result that we stop managing our condition well.

This narrative review also noted the ironic consequence of the landmark Diabetes Prevention Program. This study reported 15 years ago that “changes in lifestyle” can often stop the progression of prediabetes to diabetes. Type 2 diabetes is now widely known as a “lifestyle disease,” blaming the victim and further contributing to the stigma of the condition.

Education is the best hope

The best hope for reducing the stigma of diabetes, the narrative review concluded, will likely be education. Another ironic consequence, this time a positive one, is that as the diabetes epidemic continues to grow, diabetes knowledge will spread along with the condition itself.

This article is based on an earlier version of my article published by HealthCentral.

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Posted in: Psychosocial

Manage Your Diabetes with Yoga

August 27th, 2016 · Comments Off

Is your blood glucose level is higher than you and your doctor would like it to be? Then, a yoga practice may be just what you need for your diabetes management.

In the past few months, three different diabetes professional journals coincidentally published separate review studies of yoga for diabetes. Each of these studies reached the tentative conclusion that doing yoga will probably help you to have better health.

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Posted in: Exercise For Diabetes, Psychosocial

Doctors For and Against Patient-centered Care

July 28th, 2016 · Comments Off

It seemed obvious to me that everyone now favors patient-centered care. Then I went to New Orleans in June for the convention of the American Diabetes Association. It’s the world’s largest annual meeting of diabetes professionals.

In a mini-symposium on “Patient-centered care: Is there too much of a good thing?” one medical doctor argued that there is. Another one supported patient-centered care.

René Rodríguez-Gutiérrez, MD, Wants Patient-centered Care

Shouldn’t your diabetes care be focused on the kind of treatment that you want? Aren’t you the one who has the most at stake from your treatment? Aren’t you the person who pays for it?

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Posted in: Psychosocial

Mindfulness Leads to Better Blood Glucose

April 27th, 2016 · Comments Off

Credit: Pixabay

Better blood glucose levels are linked to mindfulness in a new study by Brown University researchers. Because sustained high blood glucose levels lead to the complications of diabetes and prediabetes, nothing could be more important for us.

The study measured several physical and psychological health indicators in 399 volunteers who participate in the New England Family Study. Eric B. Loucks, PhD, and five colleagues published the study, “Associations of Mindfulness with Glucose Regulation and Diabetes,” in the March 2016 issue of the American Journal of Health Behavior. Dr. Loucks is assistant professor of epidemiology at Brown University’s School of Public Health.

Only the abstract of the study is free online, but on my request a representative of Brown University provided me with a copy of the manuscript that Dr. Loucks had written for publication. This let me learn all the details of the study and provided an analysis of how the findings relate to those of us who have to live with diabetes or prediabetes.

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Posted in: Psychosocial

The Good News About Diabetes in 2015

January 22nd, 2016 · Comments Off

The year 2015 brought more good news to people with diabetes than any year since a doctor told me 22 years ago that my A1C level of 14.4 meant that I had diabetes. At that time I weighed more than 300 pounds and didn’t get any exercise.

But because I have been a journalist for most of my life, I decided to learn everything I could about diabetes. For the past two decades I have written about diabetes here, and for the past 10 years I have shared what I know about managing it in my posts and slideshows at HealthCentral.com.

phylissa.jpg

Phyllisa Deroze

I know that diabetes isn’t a progressive disease, in spite of what some people think. I also know that well-managed diabetes causes nothing. From my personal experience I know that you can be healthier than you ever were — if you get more active, lose weight, take your medicine, and cut your stress.

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Posted in: Diabetes Developments, Psychosocial

Did You Set Your Diabetes Goals?

January 18th, 2016 · 1 Comment

I celebrated the new year on December 21, when it started. Like me, you can celebrate it with good intentions for diabetes health.

stone

Most people celebrate ten days later on what our calendar says is New Year’s Eve. After a night of partying, it’s typical to respond with good intentions to turn over a new leaf in the next 365 or 366 days. These resolutions are made to be broken because we not only aim too late but we also aim too high.

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Posted in: Psychosocial

Diabetes Educators Can Help Us Manage Blood Glucose

January 13th, 2016 · Comments Off

Diabetes self-management education, which is known as DSME,  leads to a statistically significant decrease in A1C levels. That’s the conclusion of a systematic review of 118 studies. But this review doesn’t support the recommendation of the American Diabetes Association that the best time for this education is right after diagnosis.

The Worse Your Level the More This Helps

The review shows that this diabetes education typically improves blood glucose control by about 0.6 percent more than the usual care that we get. While this may not sound like a lot, it is. For example, if your A1C is 9.0 you can expect that it will drop to 8.4 after you get educated in this way.

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Posted in: Psychosocial

Give Thanks This Year for Your Diabetes

December 11th, 2015 · 1 Comment

During this holiday season, when most of us in the Western world have too much to eat, I encourage you to give thanks for the abundance we can enjoy even while we suffer from diabetes. Consider, if you will, what diabetes and gratitude have in common?

Actually, they share two important things. First, they share the month of November every year, and second, all of us who have diabetes have much for which we can give special thanks.

diabetes month

By presidential proclamation November 2015 is “National Diabetes Month.” On October 30, President Obama called on all of us to “raise diabetes awareness and help prevent, treat, and manage the disease.”

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Posted in: Psychosocial

Social Relationships Reduce Our Risk

August 24th, 2015 · 2 Comments

When you nurture your social relationships, you are doing something as important for your health as your physical activity, your weight, and the other well-known risk factors. For those of us who have diabetes, managing our blood sugar certainly has to come first, but nothing else matters as much as having a healthy social life.

Friends

If you are socially isolated, you increase inflammation in your body and damage your immune system. It can be a factor leading to diabetes, arthritis, and heart disease. But when you surround ourselves with supportive friends, even managing your blood sugar is easier.

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Posted in: Psychosocial

Reduce Stress to Improve Your Diabetes Control

June 27th, 2015 · 6 Comments

Article By Cathy Bykowski

Stress. Only six letters long, yet this word is so incredibly powerful. Stress has the ability to influence so much of our lives, relationships, moods, and health. For people with diabetes, stress can be particularly damaging. However, understanding what stress is, how it affects your body, and how to overcome it can begin to take its power away.

Stress is the result of your daily demands outweighing your available resources. At any given minute you have a set number of resources, which can be tangible, like money or food, or intangible, like time or patience. As long as you have enough resources to meet the demands that are placed on you, life is good. For example, your bills (demands) come in and you have plenty of money (resources) in your bank account. No problem – your demands are easily met by your resources and you have no stress. However, if the demands that are placed on you are greater than your resources, you feel it. For example, let’s say you are working against a deadline that is fast approaching. You may feel that the work you still have to do (demands) is much greater than the time left to do it (resources). This is when you experience that familiar feeling called stress.

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Posted in: Psychosocial

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