CUTTING EDGE Diabetes Care and Education
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2018 | Volume 39 | Number 6 Diabetes Care A Peer-Reviewed Publication and Education a dietetic practice group of the ON THE CUTTING EDGE Diabetes Care and Education ADDRESSING THE MENTAL HEALTH NEEDS AND PSYCHOSOCIAL BARRIERS TO SELF-CARE FOR PEOPLE WITH DIABETES 4 Overview of Common Psychosocial Message from the Theme Editor: Barriers among People With Diabetes Hope S. Warshaw, MMSc, RD, CDE, BC-ADM Owner, Hope Warshaw Associates, LLC 7 The Experience of Diabetes Asheville, NC Stigma and the Role Health Care Providers Play The time is now that health care is raising awareness about: the unique providers, including nutrition emotional and mental health needs of Family Relationships and 9 professionals, educate ourselves about people with diabetes, the unique Dynamics as a Psychosocial and attend, with greater intentionality, distress that managing this demanding Barrier in Diabetes to the emotional wellbeing and mental 24/7 disease can cause, the stigma that 12 Cultural Considerations for health needs of people with diabetes swirls around diabetes, the language Counseling Hispanic/Latino-, and their caregivers. This is a critically health care providers and society-at- Black/African- and Rural important, yet often neglected focus of large use to talk about diabetes and to Americans with Diabetes our work to achieve successful diabetes people with diabetes, the need for self-care and management outcomes. person-centered holistic care, the value 16 Practical Techniques to Address The good news is that we’re seeing of peer support, and more. Drawing Psychosocial Barriers among escalating attention to this topic in attention to these topics, educating People with Diabetes recent publications (1), practice papers nutrition professionals about their (2), position statements (3), standards importance and offering a bevy of 19 Applying Minimally Disruptive of care (4,5) and consensus reports (6). additional reading and resources are Medicine in People with Diabetes You’ll see these publications noted and the key objectives of this OTCE. to Overcome Life and Self-care detailed in the pages ahead. Challenges Work on this OTCE began nine months Some of the increased attention has ago when Janice MacLeod, MA, RD, LDN, 24 The Value of Peer Support for been fueled by greater engagement CDE, FAADE, DCE’s amazing OTCE editor, People with Diabetes and How in dialogue, be it via social media/ asked me if I would be the theme editor. Health Care Providers Can Promote in Practice networking or at conferences and other It didn’t take me long to say yes because meetings, between people with diabetes, this is a topic I’ve engaged with and 28 Polonsky’s Pearls for Practice in their caregivers and health care providers, been passionate about for years. The Diabetes Care diabetes-focused organizations and next step was to assemble a diverse their leaders and the diabetes industry. theme team to map out an OTCE on this 30 Diabetes Associations Recognize Some has been fueled by more mental topic. Goal accomplished! The theme Importance of Mental Health and health providers specializing in diabetes team includes Mark Heyman, PhD, CDE, Champion Provider Training care and more research. Collectively this Monique Richard, MS, RDN, LDN, ON THE CUTTING EDGE Anna Norton, MS, and Toby Smithson, leadership in diabetes stigma and the Diabetes Care and Education MS, RDN, LD, CDE, and represents a importance of using person-centered group of individuals with deep clinical language (7). This article is diabetes and nutrition management intentionally placed second because experience as well as, for some, the we hope OTCE readers will explore lived experience of having diabetes the part they play in perpetuating NewsFLASH and On the Cutting Edge are bi-monthly publications of the Diabetes Care and Education for many years. We jointly identified diabetes stigma and how to begin to (DCE) Dietetic Practice Group of the Academy of topics to cover and contacted capable use less stigmatizing language while Nutrition and Dietetics (the Academy). authors. Each theme team member encouraging others in your practice Print Communications Chair: became point person for one or more settings to do so too. And please raise Kathy Warwick, RD, LD, CDE articles and worked with authors and awareness where and when you can! NewsFLASH Editor: Britt Rotberg, MS, RD, BCADM, CDE peer reviewers to craft this cadre of excellent articles. I thank each of them Without a doubt the relationships a On the Cutting Edge Editor: Janice MacLeod, MA, RD, LDN, CDE, FAADE for their dedication to this OTCE! And person with diabetes has with family On the Cutting Edge Associate Editor: a big thanks to Janice MacLeod, RD, members and others in their daily Sarah Williams, MS, RD, CDE CDE, and other contributors listed orbit can have significant impact on Content printed in these publications does not imply on page 23. their emotional wellbeing and self- a statement of policy or endorsement by the DCE. The care behaviors. Janis Roszler, LMFT, opinions expressed represent those of the authors and do not reflect official policy of the Academy. As you’ll see, we’ve tapped experts RD, LD/N, CDE, a dietitian and Mention of product names in this publication does who present content on a breadth of licensed marriage and family not constitute endorsement by DCE or the Academy. topics focused on the mental health therapist, offers readers practical All material appearing in the NewsFLASH and and psychosocial barriers to diabetes pointers to work effectively with On the Cutting Edge is covered by copyright and may be photocopied or otherwise reproduced for care. This OTCE issue appropriately people with diabetes and their noncommercial scientific or educational purposes starts with an “Overview of Common loved ones in her article, “Family only, provided the source is acknowledged. Special arrangements for permission are required from the Psychosocial Barriers among People Relationships and Dynamics as a Print Communications Coordinator for any other with Diabetes.” Mark Heyman, PhD, Psychosocial Barrier in Diabetes Care.” purpose. CDE, psychologist, diabetes educator She importantly encourages us to be Subscriptions are available for people who are ineligible for Academy membership for $35 and person with diabetes, details the aware of our biases as we counsel. (domestic) and $40 (international) by sending most common psychosocial barriers a check to: to diabetes care including: emotional Being aware and respectful of unique Linda Flanagan Vahl DCE Administrative Manager barriers, cognitive barriers, social cultural barriers that can play a Academy of Nutrition and Dietetics barriers and coping barriers. significant role in successful 120 South Riverside Plaza, Suite 2190 Chicago, IL 60606-6995 implementation of diabetes self-care Our next article, “The Experience behaviors. In the article, “Cultural Payable to Academy of Nutrition and Dietetics/DCE noting preferred mailing address. of Diabetes Stigma and the Role Considerations for Counseling ©2019 Diabetes Care and Education Healthcare Providers Play,” is Hispanic/Latino-, Black/African- and Dietetic Practice Group/Academy of Nutrition and Dietetics. authored by Susan Guzman, PhD, Rural Americans with Diabetes,” we All rights reserved. Library of Congress National Serials Data Program a psychologist who specializes in engaged several authors to share their ISSN #1070-5945, issued 7/93. diabetes and is well known for her expertise working with people of STRATEGIC PRIORITY AREAS MISSION GOAL 1: The public trusts and recognizes DCE members as food, Empowering DCE members to nutrition, and diabetes experts be leaders in food, nutrition, and diabetes care and prevention. GOAL 2: DCE members optimize the health of individuals and populations impacted by diabetes VISION Optimizing the health of people GOAL 3: Membership and prospective members view DCE as vital impacted by diabetes using food, to professional success nutrition, and self-management education. these cultures, all who experience a The role and value of various types of References higher than average incidence of peer support for people with diabetes 1. Gonzalvo JD, De Groot M, Rinker J, diabetes. Raquel Franzini Pereira, MS, and their caregivers has been an area Hilligoss AR, Vu AL. Mental health in RDN, CPPM, CSM, shared her expertise of recent research and interest. CEO of people with diabetes: A needs assessment for the diabetes educator. on counseling individuals of Hispanic/ DiabetesSisters Anna Norton, MS, and AADE in Practice. 2018;6(5):30–33. Latino backgrounds. Robin Nwankwo, I went directly to people with diabetes 2. American Association of Diabetes MPH, RDN, CDE, shared her expertise and caregivers to bring you their Educators. AADE Practice Paper: A on counseling individuals of Black/ insights and perspectives about why practical approach to mental health for the diabetes educator. Published African background and Karen R. Bailey, peer support has made a difference in 2018. https://www.diabeteseducator. MS, RD, LD, CDE, and Elizabeth A. their lives with diabetes. An intent of org/docs/default-source/practice/ Beverly, PhD, shared their expertise this article, “The Value of Peer Support practice-documents/practice-papers/ from rural Ohio. Diana M. Naranjo, PhD, for People with Diabetes and How a-practical-approach-to-mental- health-for-the-diabetes-educator--- a psychologist focused on the Health Care Providers can Promote in final-v2.pdf?sfvrsn=2. Accessed psychosocial needs of people and Practice” is to encourage nutrition November 10, 2018. families with diabetes, authored the professionals to refer people you 3. Young-Hyman D, de Groot M, Hill- Briggs F, Gonzalez JS, Hood K, Peyrot introduction and conclusion. counsel to peer support with references M. Psychosocial care for people with to resources that can help you do this. diabetes: A position statement of As the concluding bookend to his As you’ll read, peer support can be life the American Diabetes Association. first article, Mark Heyman, PhD, CDE, changing. Diabetes Care. 2016;39(12):2126–2140. 4.