Notifications
Clear all
Topic starter
Recent research on the mental health impacts of diabetes self-management indicates that psychological challenges, like depression and anxiety, can directly impede an individual's capacity to manage his or her diabetes effectively. Mental health problems mainly contribute to a loss of motivation and disrupted lifestyles, preventing patients with diabetes from maintaining treatment plans, monitoring blood glucose, and adopting continuous self-care practices. Thus, interventions that aid in resolving mental health can significantly contribute to better outcomes of diabetes.
Community-based programs and peer-support initiatives have been known to influence mental well-being in a positive direction, as well as diabetes management. Behavioral interventions, which include social support, problem solving, and goal-setting techniques, have been found to enhance good glycemic control. Research shows that these interventions can be of great effectiveness even in a community with low resources, where the population may lack access to healthcare services easily. Peer support, in particular, provides emotional relief and encouragement, helping individuals maintain a positive attitude toward their health goals despite psychological stressors (1).
Digital health solutions also create an avenue through which scalable, cost-effective mental health support can be addressed. Frontiers in Public Health study has focused on the fact that digital tools reduce barriers in obtaining mental health care during diabetes management. Combining psychological interventions with technology, such solutions provide accessible ways through which people in diverse communities can deal with the physical and mental aspects of diabetes, supporting mental well-being while reducing diabetes-related distress (2) (3).
In addition, the feasibility and effectiveness of integrating mental health support within diabetes care, particularly within community-based and digital models aimed at enhancing outcomes and quality of life for people with diabetes.
References:
1. Zu, W., Zhang, S., Du, L., Huang, X., Nie, W., & Wang, L. (2024). The effectiveness of psychological interventions on diabetes distress and glycemic level in adults with type 2 diabetes: a systematic review and meta-analysis. BMC Psychiatry, 24(1). //doi.org/10.1186/s12888-024-06125-
2. ElSayed, N. A., Grazia Aleppo, Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Darville, A., Laya Ekhlaspour, Hassanein, M., Hilliard, M. E., Johnson, E. L., Kamlesh Khunti, Ildiko Lingvay, Matfin, G., McCoy, R. G., Perry, M. L., Pilla, S. J., Polsky, S., Priya Prahalad, & Pratley, R. E. (2023). 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care, 47(Supplement_1), S77–S110. //doi.org/10.2337/dc24-s005
3. Doherty, A. M. (2022). Editorial: Psychological Interventions to Improve Diabetes Self-Management. Frontiers in Clinical Diabetes and Healthcare, 3. //doi.org/10.3389/fcdhc.2022.931125
Posted : November 14, 2024 12:34 pm
Psychological disorder is the second most common cause of loss of disability-related life years and the third leading cause of disability-adjusted life years (DALY). There are two negative side effects of depression on the patients themselves and society: less active life and increased loss of productivity.
Approximately 15% of diabetic patients have major depression, whereas 9% of the general population have depression. Diabetes mellitus and its effects generally have a high national economic burden, as it increases healthcare costs. As such, effective management approaches are needed. The management of diabetes is lifelong and multidimensional, focusing majorly on controlling blood sugar levels. Although medical management is key in DM management, the patients’ self-care management is also highly important; it is the key to better health and contributes to approximately 95% of DM management.
Self-care management is defined as people engaging to improve their health, prevent disease, limit activities to improve their own health, limit illness, and regain health. Self-care-management is critical for glycemic control. Poor glycemic control is associated with poor self-management. Self-management consists of various components, including adhering to the diet pattern, performing routine blood glucose tests, engaging in regular physical activity, utilizing health centers, and achieving a favorable overall rating for diabetes self-management.
There is a dearth of literature concerning individuals‘ experiences with diabetes during and after the pandemic regarding proactive self-care management strategies and contextual challenges that include environmental factors in developing countries. The COVID-19 pandemic has prompted individuals with type 1 and 2 diabetes to adopt alternative health-management methods, such as self-care, proactive initiatives, and daily challenges. Enhancing proactiveness, awareness, and an understanding of individuals’ needs is crucial for alleviating stress, controlling disease, and preparing for potential future health crises in the wake of the pandemic’s long-term effects.
References:
- Alhunayni N.M., Mohamed A.E., Hammad S.M. Prevalence of depression among type-II diabetic patients attending the diabetic clinic at arar national guard primary health care center, Saudi Arabia. Psychiatry J. 2020;2020:9174818. doi: 10.1155/2020/9174818.
- Fiest K.M., Jette N., Quan H., St Germaine-Smith C., Metcalfe A., Patten S.B., Beck C.A. Systematic review and assessment of validated case definitions for depression in administrative data. BMC Psychiatry. 2014;14:289. doi: 10.1186/s12888-014-0289-5.
- Alotaibi B.B. Self-Care Management Practices of Diabetic Patients Type 2 in Saudi Arabia. Open J. Nurs. 2020;10:1013–1025. doi: 10.4236/ojn.2020.1011071.
- Levin L.S., Idler E.L. Self-care in health. Annu. Rev. Public Health. 1983;4:181–201. doi: 10.1146/annurev.pu.04.050183.001145.
- Madkhali NAB. How Does the Psychological Impact of COVID-19 Affect the Management Strategies of Individuals with Type 1 and Type 2 Diabetes? A Mixed-Method Study. Healthcare (Basel). 2024 Aug 27;12(17):1710. doi: 10.3390/healthcare12171710. PMID: 39273735; PMCID: PMC11395634.
Posted : November 19, 2024 1:39 pm
Self-management of diabetes has undergone tremendous evolution in practice from concentrating purely on compliance and knowledge concerning an empowered-approach to self-management that emphasizes the mental-health component as well. Mental well-being not only serves as an input to effective self-care but as an output of educational interventions in diabetes management. Whereas the outcomes of DSME with respect to glycaemic control remain without contention, however, its effect on mental health outcomes such as diabetes distress has been mixed.
It is important to integrate mental health issues as part of DSME, because addressing psycho-emotional issues, like diabetes distress, is shown to have a dual function that is beneficial both, for patients' psychosocial states and in adherence to treatment plans. Digital tools and online communities comprise strong modern resources for diabetes self-management education (DSME), involving shared real-time data, peer support, and emotional encouragement extended among population. They pitch high into low-resource settings and are valid for innovative uses in overcoming barriers to access to care.
To address emotional and psychological aspects of diabetes alongside clinical outcomes will enhance overall quality of life and enable the maintenance of chronic self-management.
Hermanns, N., Ehrmann, D., Finke-Groene, K., & Kulzer, B. (2020). Trends in diabetes self-management education: Where are we coming from and where are we going? Diabetic Medicine, 37(3), 436–447. https://doi.org/10.1111/dme.14256
Posted : November 26, 2024 9:53 am
In India, over 101 million individuals are currently diagnosed with diabetes, and effective self-management remains a challenge due to the interplay of mental health issues such as stress, depression, and anxiety. These mental health conditions are known to impair adherence to self-care behaviors, including medication, diet, and exercise. Psychological distress also increases the risk of complications and worsens glycemic control, creating a vicious cycle between mental health and diabetes management (Chowdhury et al., 2022; Sharma et al., 2023).
Research indicates that up to 86% of individuals with diabetes in India report significant levels of stress, depression, or anxiety. These challenges are compounded by stigma and limited access to mental health care, particularly in rural areas (Sharma et al., 2023). Financial stress in low-income communities hinders access to medication and healthy diets, both essential for diabetes management (Chowdhury et al., 2022).Indian women, especially in rural areas, often prioritize family needs over personal health, leading to neglect of both diabetes care and mental well-being (Rajkumar et al., 2022).
Peer groups in states like Kerala and Tamil Nadu have successfully fostered emotional resilience and better management outcomes by reducing isolation and stigma (Sharma et al., 2023). Accredited Social Health Activists (ASHAs) are increasingly involved in delivering mental health screenings and providing support for diabetes management, thereby addressing psychological and medical needs simultaneously (Chowdhury et al., 2022). Mobile health applications are bridging gaps in care by enabling real-time monitoring and remote counseling, particularly for underserved populations (Rajkumar et al., 2022).
Addressing the mental health dimension of diabetes management in India requires integrating psychological support into community health initiatives. Expanding such integrated care models can help mitigate the dual burden of diabetes and mental health issues, improving outcomes and quality of life for millions.
References
Chowdhury, R., et al. (2022). Community-based diabetes and mental health interventions in India: A holistic approach to self-management. Indian Journal of Public Health.
Sharma, V., et al. (2023). The psychosocial burden of diabetes in India: An emerging public health challenge. Diabetes Management Journal.
Rajkumar, R., et al. (2022). Gender disparities in diabetes care and mental health: Insights from rural India. Journal of Health and Social Behavior.
Posted : November 26, 2024 11:28 am
Posted : November 26, 2024 11:06 pm
The study on diabetes self-management in Northern Mexico highlights the intertwined relationship between mental health and diabetes care, emphasizing that depression, anxiety, and stress often undermine self-management behaviors like glucose monitoring, diet adherence, and physical activity. The Meta Salud Diabetes (MSD) intervention demonstrated significant benefits, including improved self-efficacy and enhanced social support, empowering participants to take control of their health while fostering peer relationships that alleviated isolation and motivated sustained care. Additionally, health workers observed reductions in diabetes-related distress and depression among participants, driven by increased knowledge and practical strategies. However, the study identified opportunities for improvement, notably the integration of family support and mental health services into diabetes care. Family education was seen as vital to fostering understanding and reinforcing lifestyle changes, while the inclusion of consistent mental health professionals was deemed essential to address emotional challenges comprehensively. These findings suggest that holistic, community-based programs that integrate mental health, family involvement, and innovative tools like digital health solutions can effectively address the dual burdens of diabetes and mental health, particularly in low-resource settings.
Aceves, B., Ruiz, M., Ingram, M. et al. Mental health and diabetes self-management: assessing stakeholder perspectives from health centers in Northern Mexico. BMC Health Serv Res 21, 177 (2021). //doi.org/10.1186/s12913-021-06168-y
Posted : November 27, 2024 4:22 pm
the mental health challenges that can significantly affect an individual's ability to manage their condition. Depression and anxiety can indeed impede self-care practices, making it difficult for patients to follow treatment plans and monitor their blood glucose levels consistently.Recent research on the mental health impacts of diabetes self-management indicates that psychological challenges, like depression and anxiety, can directly impede an individual's capacity to manage his or her diabetes effectively. Mental health problems mainly contribute to a loss of motivation and disrupted lifestyles, preventing patients with diabetes from maintaining treatment plans, monitoring blood glucose, and adopting continuous self-care practices. Thus, interventions that aid in resolving mental health can significantly contribute to better outcomes of diabetes.
Community-based programs and peer-support initiatives have been known to influence mental well-being in a positive direction, as well as diabetes management. Behavioral interventions, which include social support, problem solving, and goal-setting techniques, have been found to enhance good glycemic control. Research shows that these interventions can be of great effectiveness even in a community with low resources, where the population may lack access to healthcare services easily. Peer support, in particular, provides emotional relief and encouragement, helping individuals maintain a positive attitude toward their health goals despite psychological stressors (1).
Digital health solutions also create an avenue through which scalable, cost-effective mental health support can be addressed. Frontiers in Public Health study has focused on the fact that digital tools reduce barriers in obtaining mental health care during diabetes management. Combining psychological interventions with technology, such solutions provide accessible ways through which people in diverse communities can deal with the physical and mental aspects of diabetes, supporting mental well-being while reducing diabetes-related distress (2) (3).
In addition, the feasibility and effectiveness of integrating mental health support within diabetes care, particularly within community-based and digital models aimed at enhancing outcomes and quality of life for people with diabetes.References:
1. Zu, W., Zhang, S., Du, L., Huang, X., Nie, W., & Wang, L. (2024). The effectiveness of psychological interventions on diabetes distress and glycemic level in adults with type 2 diabetes: a systematic review and meta-analysis. BMC Psychiatry, 24(1). //doi.org/10.1186/s12888-024-06125-
2. ElSayed, N. A., Grazia Aleppo, Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Darville, A., Laya Ekhlaspour, Hassanein, M., Hilliard, M. E., Johnson, E. L., Kamlesh Khunti, Ildiko Lingvay, Matfin, G., McCoy, R. G., Perry, M. L., Pilla, S. J., Polsky, S., Priya Prahalad, & Pratley, R. E. (2023). 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care, 47(Supplement_1), S77–S110. //doi.org/10.2337/dc24-s005
3. Doherty, A. M. (2022). Editorial: Psychological Interventions to Improve Diabetes Self-Management. Frontiers in Clinical Diabetes and Healthcare, 3. //doi.org/10.3389/fcdhc.2022.931125
Community-based programs and peer-support initiatives are invaluable in this regard. They not only provide practical support and problem-solving strategies but also offer emotional relief and encouragement. Such support can help individuals maintain a positive attitude toward their health goals, even in the face of psychological stressors. The effectiveness of these interventions, especially in resource-limited settings, underscores the importance of social support in managing chronic conditions like diabetes.
Furthermore, the role of digital health solutions in providing scalable and accessible mental health support cannot be overstated. By integrating psychological interventions with technology, we can reduce barriers to care and offer continuous support to individuals managing both the physical and mental aspects of diabetes. This holistic approach is crucial for improving both health outcomes and quality of life for people with diabetes.
Posted : December 2, 2024 1:21 pm
Recent research on the mental health impacts of diabetes self-management indicates that psychological challenges, like depression and anxiety, can directly impede an individual's capacity to manage his or her diabetes effectively. Mental health problems mainly contribute to a loss of motivation and disrupted lifestyles, preventing patients with diabetes from maintaining treatment plans, monitoring blood glucose, and adopting continuous self-care practices. Thus, interventions that aid in resolving mental health can significantly contribute to better outcomes of diabetes.
Community-based programs and peer-support initiatives have been known to influence mental well-being in a positive direction, as well as diabetes management. Behavioral interventions, which include social support, problem solving, and goal-setting techniques, have been found to enhance good glycemic control. Research shows that these interventions can be of great effectiveness even in a community with low resources, where the population may lack access to healthcare services easily. Peer support, in particular, provides emotional relief and encouragement, helping individuals maintain a positive attitude toward their health goals despite psychological stressors (1).
Digital health solutions also create an avenue through which scalable, cost-effective mental health support can be addressed. Frontiers in Public Health study has focused on the fact that digital tools reduce barriers in obtaining mental health care during diabetes management. Combining psychological interventions with technology, such solutions provide accessible ways through which people in diverse communities can deal with the physical and mental aspects of diabetes, supporting mental well-being while reducing diabetes-related distress (2) (3).
In addition, the feasibility and effectiveness of integrating mental health support within diabetes care, particularly within community-based and digital models aimed at enhancing outcomes and quality of life for people with diabetes.References:
1. Zu, W., Zhang, S., Du, L., Huang, X., Nie, W., & Wang, L. (2024). The effectiveness of psychological interventions on diabetes distress and glycemic level in adults with type 2 diabetes: a systematic review and meta-analysis. BMC Psychiatry, 24(1). //doi.org/10.1186/s12888-024-06125-
2. ElSayed, N. A., Grazia Aleppo, Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Darville, A., Laya Ekhlaspour, Hassanein, M., Hilliard, M. E., Johnson, E. L., Kamlesh Khunti, Ildiko Lingvay, Matfin, G., McCoy, R. G., Perry, M. L., Pilla, S. J., Polsky, S., Priya Prahalad, & Pratley, R. E. (2023). 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care, 47(Supplement_1), S77–S110. //doi.org/10.2337/dc24-s005
3. Doherty, A. M. (2022). Editorial: Psychological Interventions to Improve Diabetes Self-Management. Frontiers in Clinical Diabetes and Healthcare, 3. //doi.org/10.3389/fcdhc.2022.931125
Mental Health Impacts on Diabetes Self-Management in Community Settings
The relationship between mental health and diabetes self-management is a critical and complex issue. Psychological challenges, such as depression and anxiety, can significantly hinder an individual's ability to effectively manage diabetes. This article explores the mental health impacts on diabetes self-management within community settings and highlights the importance of integrated care approaches.
The Psychological Burden of Diabetes
Diabetes is not just a physical condition; it also has profound psychological implications. Managing diabetes requires constant attention to diet, medication, blood glucose monitoring, and lifestyle adjustments. For many, this relentless routine can lead to mental health issues such as depression, anxiety, and diabetes distress. These psychological challenges can, in turn, create a vicious cycle where poor mental health exacerbates diabetes management difficulties, leading to worse health outcomes.
Impact of Mental Health on Diabetes Self-Management
1. Loss of Motivation: Depression and anxiety can diminish an individual's motivation to adhere to diabetes management plans. This includes taking medications, following dietary guidelines, and regularly monitoring blood glucose levels.
2. Disrupted Lifestyles: Mental health issues often lead to lifestyle disruptions, making it difficult for individuals to maintain consistent self-care practices. Irregular sleep patterns, poor dietary choices, and reduced physical activity are common consequences.
3. Cognitive Challenges: Anxiety and depression can impair cognitive functions such as memory and decision-making, complicating the daily tasks involved in diabetes self-management.
The Role of Community-Based Programs
Community-based programs have shown promise in addressing the mental health needs of individuals with diabetes. These programs offer social support, education, and practical strategies to improve both mental health and diabetes outcomes. Key components of successful community-based interventions include:
1. Peer Support: Engaging with peers who face similar challenges provides emotional relief and encouragement. Peer support groups offer a platform for sharing experiences, advice, and coping strategies.
2. Behavioral Interventions: Techniques such as problem-solving, goal-setting, and stress management are integral to these programs. Behavioral interventions help individuals develop the skills needed to manage both their diabetes and mental health effectively.
3. Accessibility and Inclusivity: Community-based programs are particularly beneficial in low-resource settings where access to healthcare services may be limited. These programs can bridge the gap, providing essential support where it is needed most.
Digital Health Solutions
In addition to community-based programs, digital health solutions are emerging as a valuable tool for supporting mental health and diabetes management. Mobile apps, online platforms, and telehealth services offer scalable and cost-effective ways to provide mental health support. These digital tools can:
1. Reduce Barriers to Care: Digital solutions make mental health support more accessible, especially for those in remote or underserved areas.
2. Provide Continuous Support: Technology enables ongoing monitoring and support, helping individuals stay on track with their diabetes management and mental health care.
3. Facilitate Integrated Care: Combining psychological interventions with digital health platforms allows for a holistic approach to diabetes management, addressing both physical and mental health needs.
Conclusion
The interplay between mental health and diabetes self-management is a significant factor in overall health outcomes. Community-based programs and digital health solutions play a crucial role in providing the necessary support to individuals managing diabetes. By addressing the mental health challenges associated with diabetes, these interventions can enhance self-management practices, improve glycemic control, and ultimately lead to better quality of life for those affected by this chronic condition.
Integrating mental health support into diabetes care, particularly through accessible community-based and digital models, is essential for addressing the comprehensive needs of individuals with diabetes. This holistic approach not only improves health outcomes but also empowers individuals to manage their condition more effectively, fostering resilience and well-being in community settings.
Posted : December 2, 2024 1:25 pm
Persons with Diabetes can have Diabetes Burnout due to feeling run down, emotionally drained and completely overwhelmed. Complex environmental, social, behavioural, and emotional factors, known as psychosocial factors, influence living with diabetes, both type 1 and type 2, and achieving satisfactory medical outcomes and psychological well-being. Thus, individuals with diabetes and their families are challenged with complex, multifaceted issues when integrating diabetes care into daily life. To promote optimal medical outcomes and psychological well-being, patient-centred care is essential, defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions”. Practising personalized, patient-centred psychosocial care requires that communications and interactions, problem identification, psychosocial screening, diagnostic evaluation, and intervention services take into account the context of the person with diabetes (PWD) and the values and preferences of the PWD. Diabetes care providers should provide psychosocial assessment and care for PWD and their families.
Mental health issues such as depression, anxiety, and stress can significantly affect an individual's ability to manage diabetes effectively. For instance, depression is common among people with diabetes and can lead to poor self-care behaviours, such as unhealthy eating, physical inactivity, and non-adherence to medication. Conversely, the stress of managing diabetes can exacerbate mental health issues. Community-based organizations (CBOs) and community health workers (CHWs) play a vital role in supporting diabetes self-management. These entities can provide Diabetes Self-Management Education and Support (DSMES) services, which are essential for helping individuals manage their condition and improve their quality of life.DSMES services can include education on healthy eating, physical activity, medication adherence, and coping strategies for stress and emotional well-being. Integrating mental health services with diabetes care in community settings can lead to better health outcomes. For example, providing access to mental health professionals who can address issues like depression and anxiety can improve diabetes management and overall well-being. This holistic approach ensures that both physical and mental health needs are met. Addressing mental health in diabetes care also involves reducing stigma and encouraging individuals to seek help. Community settings can offer a supportive environment where individuals feel comfortable discussing their mental health challenges and accessing necessary resources. Education is a powerful tool in managing both diabetes and mental health. Community programs that educate individuals about the connection between mental health and diabetes can empower them to take proactive steps in managing their health. This includes recognizing symptoms of mental health issues and knowing when and how to seek help.
Diabetes distress is very common and is distinct from a psychological disorder. The constant behavioural demands (medication dosing, frequency, and titration; monitoring blood glucose, food intake and eating patterns, and physical activity) of diabetes self-management and the potential or actuality of disease progression are directly associated with reports of diabetes distress. Its prevalence is reported to be 18–45% with an incidence of 38–48% over 18 months. High levels of diabetes distress significantly impact medication-taking behaviours and are linked to higher A1C, lower self-efficacy, and poorer dietary and exercise behaviours. It may be helpful to provide counselling regarding expected diabetes-related versus generalized psychological distress at diagnosis and when disease state or treatment changes
GENERAL CONSIDERATIONS IN PSYCHOSOCIAL CARE
Recommendations
-
Psychosocial care should be integrated with collaborative, patient-centred medical care and provided to all people with diabetes, with the goal of optimizing health outcomes and health-related quality of life.
-
Providers should consider an assessment of symptoms of diabetes distress, depression, anxiety, and disordered eating and of cognitive capacities using patient-appropriate standardized/validated tools at the initial visit, at periodic intervals, and when there is a change in disease, treatment, or life circumstance. Including caregivers and family members in this assessment is recommended.
-
Consider monitoring the patient's performance of self-management behaviours as well as psychosocial factors impacting the person’s self-management.
-
Consider assessment of life circumstances that can affect physical and psychological health outcomes and their incorporation into intervention strategies.
-
Addressing psychosocial problems upon identification is recommended. If an intervention cannot be initiated during the visit when the problem is identified, a follow-up visit or referral to a qualified behavioural health care provider may be scheduled during that visit.
-
People with diabetes should be evaluated and receive training until they attain competence in diabetes self-care skills and the use of technologies at the time of diagnosis, annually, if/when complications arise, and if/when transitions in care occur. The diabetes care team is encouraged to directly and regularly assess these self-management behaviours.
-
Providers should consider the burden of treatment and patient levels of confidence/self-efficacy for management behaviors as well as level of social and family support when making treatment recommendations.
PWD are diagnosed earlier (e.g., type 2 diabetes in childhood) and living longer. At each point in the life course, providers should consider which resources and accommodations are needed to maximize disease outcomes and well-being. In particular, the identification of psychosocial factors influencing self-management is recommended (e.g., culture, environment, social determinants, life roles and responsibilities, and interpersonal dynamics, as well as person-based characteristics such as sex, race/ethnicity, age, language, and socioeconomic status).
In conclusion, addressing mental health is integral to effective diabetes self-management in community settings. By leveraging community resources and integrating mental health services, we can support individuals in achieving better health outcomes and improving their quality of life. PWD must master many complex tasks and behaviours to successfully incorporate diabetes care into daily life. Disease management cannot be successful unless the lifestyle and emotional status of the individual is taken into consideration. The effectiveness of the regimen and care provision will be enhanced by the inclusion of behavioural health services into the diabetes treatment team. Collaborative care shows the most promise for supporting physical and behavioural health outcomes.(Community-Based Organizations, 2024) (“Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association,” n.d.)
Psychosocial care for people with diabetes: A position statement of the American Diabetes Association. (n.d.). American Diabetes Association. //diabetesjournals.org/care/article/39/12/2126/31378/Psychosocial-Care-for-People-With-Diabetes-A
Community-Based organizations. (2024, May 15). Diabetes. //www.cdc.gov/diabetes/php/cbo-guidance/index.html
Community-Based Organizations | Diabetes | CDC
Posted : December 19, 2024 11:44 am