The European Association for the Study of Diabetes releases its first evidence-based guidelines to incorporate emotional wellbeing into standard diabetes care, highlighting the importance of addressing distress in adults with type 1 and type 2 diabetes.
The European Association for the Study of Diabetes has published what it says is the first evidence-based clinical guideline on assessing and managing diabetes distress, turning a draft released last year into a final recommendation set in Diabetologia. The guideline is aimed at adults with type 1 or type 2 diabetes and is designed to make emotional wellbeing a routine part of diabetes care, rather than an optional extra.
According to the published guideline and accompanying summary, the panel used formal evidence-review methods, including GRADE and RIGHT reporting standards, and involved people with lived experience from the outset. The final version keeps eight Good Practice Statements on assessment and adds management advice that varies by diabetes type. One notable change from the draft is a recommendation that automated insulin delivery systems may help reduce distress in adults with type 1 diabetes.
For routine care, clinicians are advised to raise the emotional side of diabetes at every consultation, ask open-ended questions about what feels hardest, and use validated questionnaires when distress needs to be measured. The guideline also says distress should be reviewed at regular intervals, at least once a year, and during major life events or treatment changes. Findings should be discussed with the patient, recorded in the notes and shared with the wider care team when relevant.
On treatment, the panel recommends psychological therapy, continuous glucose monitoring and automated insulin delivery for adults with type 1 diabetes who are distressed, although it says the benefits are small and the evidence is often low to moderate in certainty. For adults with type 2 diabetes, psychological, psychoeducational and educational interventions can all be offered alongside usual care. The guideline does not recommend continuous glucose monitoring specifically for reducing distress in type 2 diabetes, and it says there is not enough evidence to support peer support as a distress-reduction strategy. It also highlights major gaps in the evidence, including limited data from South Asia, the Middle East, Africa and South-East Asia, and no guidance for children, adolescents or adults with other forms of diabetes. The authors say the next challenge is implementation, with the recommendations needing to be built into everyday clinic workflows, adapted locally and, in some settings, translated.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
