When we talk about stopping diabetes, we usually focus on medical treatments and lifestyle changes that are required to manage the disease: eating well, exercising regularly, taking insulin or other medication, monitoring blood glucose, screening for complications and so on. And for very good reason—we know these measures save and improve the lives of people with diabetes.
Yes, we have made amazing strides in the clinical management of diabetes and the technology of treatment. But we need to play a game of “catch up” when it comes to the psychosocial aspects of this disease. I’m talking about mental health problems such as depression and diabetes distress, which are far too prevalent. They arise from the constant, and at times overwhelming, responsibilities of self-managing a chronic disease like diabetes.
A little about me: I have lived with type 1 diabetes for nearly 38 years. I was a graduate student when I was diagnosed in the 1970s, and my quest for diabetes information took me to the library. There was no literature on how to really cope with diabetes emotionally, behaviorally, psychologically. This area of research was poorly funded then, and it remains underfunded now.
Thus began my career as a diabetes researcher. For example, I have studied how children with diabetes struggle with the transition to adulthood, where continuity in diabetes management is so often lost, and how to improve it. My team is developing an app that would help young adults with diabetes learn how to handle new situations straight from peers who have “been there.” Like, how do you handle diabetes and alcohol consumption once you come of age—without letting it hinder your social life?
How can the American Diabetes Association influence this shift to treating the whole patient with diabetes—mind, body and soul?
1. I would like to work with organizations such as the American Psychological Association to train and certify psychologists to better help people adapt to life with diabetes. That means both recognizing and treating these specific mental health issues.
2. As a leader in cutting-edge diabetes research, the Association can fund new studies on behavioral and psychosocial issues. So far, we have focused more on basic and clinical science.
3. Many emotional issues come from the stress of finding and affording high-quality diabetes care. I would like to collaborate with other organizations that deal with diabetes treatment to improve services and access to new technology. I’m a big believer in emerging technologies and how it can connect people to improve their health. From insurance coverage and reimbursements, to data-sharing among diabetes devices, there are a lot of ways the United States can make good diabetes care more accessible to the people who so need it.
4. One of the greatest things the Association does is give voice to those denied their rights because of diabetes—in other words, fighting discrimination. It starts with educating employers, schools, policymakers, law enforcement and the general public about the needs of people with diabetes. As understanding and acceptance improves, the people we serve will face less stigma and fewer barriers to a normal life. They can check their blood glucose in public. They can comfortably ask for accommodations on the job. They can be Safe at School—and so much more.
Yes, these are lofty goals for my year as President. But these steps would go a long way toward our vision of a life free of diabetes and all of its burdens.
David G. Marrero, PhD
President, Health Care & Education, 2015
American Diabetes Association