Introduction
Methods
Results
Euthymia in Patients with DM (DD)
Understanding the Concept of Euthymia in Diabetes
Redefining Diabetes Distress
Prevalence of DD
Time Points in DM Patients Associated with Increased Levels of DD
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Around the time of diagnosis of DM
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At the time of learning how to self-manage DM
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At the emergence of complication
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At the time of switching medications and healthcare plans
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At the time of switching healthcare providers [6]
Differentiating DD and Clinical Depression
Screening and Diagnosis of DD
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Some of the measures do not cover a few critical areas of interest adequately. For instance, in PAID there is only one item that addresses the patients’ feelings about their healthcare provider.
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In some measures, the items may be confusing for the patient. For example, in QSD-R, one item reads, “I suffer from irritability,” but this may be difficult for the patients to comprehend.
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Measures such as ATT39, QSD-R, and PAID have established subscales, which are not brief.
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Certain critical areas of interest are not covered by these measures [9].
Management of DD
DD was redefined as an emotional response characterized by extreme apprehension, discomfort, or dejection due to a persistent perceived inability to cope with the challenges and demands of living with diabetes |
Diabetes care professionals must work to identify the cause or etiopathogenesis of DD and minimize its impact |
The 17-item DD screening scale must be preferred over the 2-item DD scale. An appropriate time interval for DD evaluation should be determined. The physician should take responsibility to identify the risks of DD and should provide adequate counseling to a patient, instead of referring the patients to other specialists |
Preventative counseling is essential for patients who are at high risk of developing psychological and psychiatric issues following a diagnosis of diabetes. Diabetes counselors need to educate the patients on the need for continued usage of medications in their counseling sessions |
Newer ideas, such as the GlucoCoper and shifting focus from suffering from diabetes to living with diabetes, may help patients in attaining and maintaining euthymia |
Physicians’ Euthymia
Background: Importance of Health and Well-Being of the Healthcare Practitioners
Adverse Health Conditions Experienced by HCPs
Important Lifestyle Changes Required to Enhance Overall Health of HCPs
Barriers to Healthy Preventative Habits among HCPs
Stress Management Strategies to Improve Health Status of HCPs
HCPs are exposed to significant health risks by virtue of their profession. Many of these health hazards remain largely unrecognized by the public and may be underestimated by the professionals themselves |
Physicians should develop a structured lifestyle to overcome health hazards. A structured program for bringing in lifestyle changes that are visible, practical, and possible can help physicians cope with the possibility of burnout |
A small gym or recreation corner in the clinic may help physicians overcome stress |
Medical students and postgraduates should be made aware of the pitfalls of hospital and clinical practice |
Work–life balance and synchronization can help improve happiness quotient among the physician community. This can be achieved if physicians can get involved in diverse aspects of patient care, such as technological innovations and patient advocacy programs |
Partnership Euthymia
Concept of Partnership Euthymia
Background: Need for Striking Smart Conversations with DM Patients: When and How?
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Diabetes is first diagnosed
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Inappropriate self-care behaviors occur
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Conflicts arise between belief systems and therapies
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Insulin therapy becomes necessary
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Cardiovascular risk is increased
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Sexual dysfunction (SD) occurs [26]
Striking Conversations with DM Patients about SD
Important Aspects of Counseling in MSD
Counseling Methods in Patients with MSD
Striking Conversations with DM Patients About CV Risk
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Graphic illustration of the atherosclerotic process using simple language, diagrams, and analogies
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Graphic description of the consequences of a CVD event, e.g., pain, disability, and death, as possible consequences of a myocardial infarction
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Use of risk calculators to predict the current risk of CVD
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Provide optimal therapeutic regimen
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Shared decision-making to develop a treatment plan [30]
Important Messages to Reinforce While Striking Smart Conversations
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Advise people with diabetes to aim for a healthy weight.
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Encourage meal planning that includes a variety of foods, controlled portion sizes, and snacks. Increasing fiber and limiting refined carbohydrates, salt, and fat will help control blood glucose, blood pressure, and cholesterol.
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Advise people with diabetes to include moderate–intense physical activity (such as brisk walking) in their daily life.
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Ask people with diabetes to identify their high-priority concerns or goals. Prompt them to plan for challenging situations and set short-term achievable goals.
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People with diabetes need to avoid smoking and using smokeless tobacco products [31].
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Daily foot care
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Eye care
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Daily oral care: brush and floss
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Monthly oral self-exam
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Selection and use of a blood glucose monitor as needed
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Knowledge of your ABC goals and how to reach them
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Use of medications as prescribed [31]
According to the expert group, a good doctor–patient rapport is crucial to make patients more comfortable and open to talk about their sexual problems |
In all newly diagnosed diabetic patients, physicians need to enquire about any SD in last 3 months |
Approach to patient during assessment for SD should be systematic, from non-threatening to threatening questions |
Diabetes mellitus patients with a favorable response to assessment should be referred for further evaluation and care to a specialist |
In this context, the clinical expert group came up with recommendations for appropriate timing for assessment of SD in male and female DM patients |
The team also suggested that a protocol for MSD and female SD assessment should be implemented in clinical practice |