Tackling Diabetes Distress Using International Expertise

Posted on 05.09.2024

Professor Jackie Sturt is leading the D-Stress Programme, aiming to develop a comprehensive care pathway for people with diabetes distress. The programme combines international expert knowledge, with significant contributions from Danish researchers.

Diabetes UK and NIHR (National Institute for Health and Care Research, UK), have invested £2.8 million into discovering, treating, and preventing diabetes distress.

The programme is led by Professor Jackie Sturt from King’s College London (KCL) who did a visiting professorship at Steno Diabetes Centre Copenhagen (SDCC) with a grant from the Danish Diabetes Academy (DDA, now the Danish Diabetes and Endocrine Academy, DDEA).

The Scope of Diabetes Distress

Diabetes distress is the emotional stress experienced when a person feels burdened or overwhelmed by living with diabetes. It is associated with elevated HbA1c and an impaired quality of life. It can lead to depression or burnout if left untreated.

Diabetes distress affects one in three people with diabetes in Denmark, according to recent numbers from SDCC, and one in four with type 1 diabetes in the UK, according to Diabetes UK.

“Despite its prevalence and impact, diabetes distress often goes unrecognised and unmanaged in diabetes care worldwide. This gap in care underscores the importance of research into effective interventions,” says Professor Jackie Sturt.

The sources of diabetes distress vary. For those with type 2 diabetes, sources include managing the condition, fears of hypoglycaemia, concerns about long-term complications, and interactions with healthcare providers and loved ones. Individuals with type 1 diabetes often face distress from feelings of powerlessness, negative social perceptions, and anxiety around eating and managing their condition.

Developing the D-stress Programme

The NIHR and Diabetes UK grant of £2.8 million funds the development and testing of a new programme called ‘D-stress’, led by Professor Jackie Sturt. The programme seeks to develop a comprehensive care pathway for diabetes distress, tailored to the National Health Service (NHS) in the UK.

“There are currently no effective treatments for diabetes distress available in the UK. Researchers in the USA, Denmark, and Australia have developed and evaluated interventions for detecting, managing, and preventing the condition. We are combining the best of those treatments to form the D-Stress Programme to see if it reduces diabetes distress and improves blood glucose levels in people with type 1 diabetes. We will also determine for whom D-stress works and in what context and understand how to implement D-Stress widely following the research,” explains Professor Jackie Sturt.

The D-Stress programme is built on three core components:

  • DDetect – detection of elevated diabetes distress
  • SUSTAIN – promotion of emotional health to prevent distress
  • REDUCE – management of elevated distress.

International Expertise in Action

The development of D-Stress is a collaborative effort involving experts like Dr. Mette Due Christensen (KCL and SDCC), Dr. Lawrence Fisher (University of California, San Fransisco), Dr. Vibeke Stenov (SDCC), and Jennifer A. Halliday (Australian Centre for Behavioural Research in Diabetes), who have all significantly contributed to shaping the programme. Stenov’s REDUCE intervention and Fisher’s methods from the US have been integrated into D-Stress, and all the contributors’ expert knowledge continues to influence its development.

Other collaborators include Ingrid Willaing (Health Services Research Consultant, formerly SDCC) and Professor Richard Holt (University of Southampton, formerly DDA visiting professor at Steno Diabetes Centre Sjælland and Psychiatry West, Slagelse).

While the D-stress programme will be specifically tailored to the NHS in the UK, Professor Sturt sees ample opportunity to adapt the programme to other countries.

“We are using several research methods to adapt the component interventions from the US, Denmark, and Australia into existing interventions in the UK NHS context. These methods can be used to take D-stress, once placed into a care pathway, to contextually adapt to other health systems and population characteristics around the world,” says Professor Jackie Sturt.

Read more about Professor Jackie Sturt’s visiting professorship.

About Diabetes Distress:

  • Diabetes Distress is the emotional stress resulting from living with diabetes and the burden of daily self-management of the condition
  • Diabetes Distress affects both mental and physical health negatively
  • Diabetes Distress is sometimes mistaken for, and is more common than, depression – and can lead to depression and/or burnout if left untreated
  • Diabetes Distress is associated with elevated HbA1c and impaired quality of life

Sources: Diabetes UK, SDCC

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