Type 2 Diabetes

 Psychological Concepts

Type 2 Diabetes is known to cause some sort of psychological distress and negative affective disorders in patients with this illness. There are a large number of patients with type 2 diabetes that suffer from clinical depression, and those who do not meet the full criteria for a depressive disorder may still suffer from distress that can cause them to engage in poor self-care, functioning across multiple domains, and quality of life (Massey, Feig, Duque-Serrano & Huffman,2017). Depression and anxiety are consistently associated with poor glucose management. Depression is associated with:

  • impaired glucose control
  • functional disability
  • end0organ complications
  • mortality
  • distress associated with poor treatment adherence

                                           

Although type 2 diabetes has negative psychological affects on patients, if a person has positive psychological characteristics such as optimism, positive affect, and gratitude can play a role in how this illness controls their life. A person can suffer from depression and still be optimistic about their future, and a person who is non depressive may have a lower level of optimism (Massey, Feig, Duque-Serrano & Huffman,2017).

Theories

There are four theories that are used to help people who suffer from type 2 diabetes.

Self Regulation Theory

Focuses on the individuals illness representation or personal model of diabetes as a key determinant of their behavioral and emotional responses to the illness. Research has identified five core elements that form our illness representations (Skinner, Cradock, Arundel & Graham, 2003):

  • identify 
  • cause 
  • consequences
  • treatment effectiveness

 Dual Process Theory

This theory is used to guide the process of education and addressing the patients current understanding of diabetes. Dual process theory makes a distinction between heuristic and systematic processing. Heuristic processing is when the patient is following the instructions given by the health care professional which is a generic and not individualized to the patients specific health needs (Skinner, Cradock, Arundel & Graham, 2003). To overcome this issue, the dual process theory is used to help educated patients on how type 2 diabetes affect their bodies personally.

Self Determination Theory 

Focuses on the difference controlled and autonomous motivation. Controlled motivation is when you do things to make others happy or to receive a reward. Autonomous motivation is when do things for yourself. This type of motivation is associated with successful self-care, weight loss, and positive glucose management (Skinner, Cradock, Arundel & Graham, 2003). When a person with type 2 diabetes uses this theory, it helps them conduct their own health assessments and record their results which leads them to make better choices as it relates lifestyle changes.  

Social Learning Theory 

This theory focuses on  the individuals perception of their ability to enact behaviors and follow through on action plans. This is often known as self- efficacy, which is know as the most consistent predictors of successful self-care and has been incorporated into most health psychology models (Skinner, Cradock, Arundel & Graham, 2003). While using this theory, it is reinforcing the message that any change, no matter how small, have benefits for improving health (Skinner, Cradock, Arundel & Graham, 2003).

Models

Ecological model expands behavior change influences beyond the individual and their family and friends to include factors such as organizations, communities, and culture ( Fisher et al., 2022; Sallis es al., 2008). Health care organizations and providers can improve their patient care and support patients in making behavior changes. Health care providers can assist with:

  • coaching
  • diabetes education classes
  • behavioral modification support
  • care delivery

There has been an increase in health systems who are using team-based care and care coordination strategies for the management of chronic diseases such as diabetes, and a central component has been patient education and support of behavior change ( Peek, Ferguson, Bergeron, Maltby, & Chin, 2014). 

 How Those in Your Environment Can Help

Support from family, friends, and peers can help patients with diabetes modify their behaviors and live a healthier lifestyle ( Peek, Harmon, et al., 2012). There are three types of social support:

  1. Perceived support- subjective judgement that others will offer or have offered help.
  2. Enacted support-supportive actions offered by others during times of need.
  3. Social integration- recipient is connected within a social network (Cohen, Shmukler, Ullman, Rivera & Walker, 2010).
Family and friends of patients with type 2 diabetes can help by:
  • learning about diabetes
  • know diabetes is individual
  • ask
  • go to appointments
  • give them time 
  • avoid blame
  • step back 
  • accept ups and downs 
  • be encouraging
  • walk the talk
  • know the lows
Please watch the video below for more information on how your environment can help with diabetes. 
https://youtu.be/LqdJPaRrbbc




References

Massey, C. N., Feig, E. H., Duque-Serrano, L., & Huffman, J. C. (2017, October 30). Psychological well-being and type 2 diabetes. Current research in diabetes & obesity journal. https://pubmed.ncbi.nlm.nih.gov/29276801/

Pink, M. E., Ferguson, M., Roberson, T., & Chin, M. (2014, November 3). Putting theory into practice: A case study of diabetes-related behavioral change interventions on Chicago’s South Side. Health promotion practice. https://pubmed.ncbi.nlm.nih.gov/25359248/

Skinner, T. C., Cradock, S., Arundel, F., & Graham, W. (2003, April 1). Four theories and a philosophy: Self-management education for individuals newly diagnosed with type 2 diabetes. American Diabetes Association. https://doi.org/10.2337/diaspect.16.2.75

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