Mental health matters as much as medication in diabetes care
Mental health issues among diabetic patients are often overlooked.
It is necessary to revolutionise diabetes care beyond just medical prescriptions from doctors but also mental health care assisted by education and awareness to patients, say experts.
Malaysian Health Ministry Disease Control Division senior assistant director, Dr Aizuniza Abdullah, emphasised that diabetes talk should go beyond mentioning its metabolic changes and physical changes but also the effect on the patient's mental health.
"This angle needs to be focused on since some patients have gone through depression because of it. Some people want to end their lives just due to the thought of cutting their legs because of diabetes," she said.
She commended the government for expanding education on diabetes, providing more comprehensive information and making it more accessible to patients. She also pointed out that mental health issues among diabetic patients are often overlooked.
"The medical staff needs to work together to continue to educate patients, as well as about the self-monitoring blood glucose (SMBG) framework and how its intervention can help patients' mental health aspects," she said.
The SMBG framework is an intervention of changing one's lifestyle in a specific timeframe, where its outcome expects the patients to be more confident with their diabetes care, with provided support from doctors and nurses around.
Experts from Alpro Pharmacy developing the framework with diabetes at-home tests as part of the self-monitoring process also found that patients who self-monitor feel more in control of their diabetes, further lowering their blood glucose in the long term for a better life expectancy and overall quality.
A panel discussion was held together with Dr Aizuniza, Alpro Pharmacy researcher and professional care and development manager Chua Kai Jia, who assisted the research using the SMBG framework, accompanied by Basmawati Baharom, a Malaysian Dietitians' Association council member and consultant endocrinologist, diabetologist, and physician Dr Chooi Kheng Chiew from KPJ Ampang Puteri, to give their insights about bettering diabetes care from aspects such as diet and mental health.
Dr Aizuniza also stressed the importance of focusing on patients from the B40 group to help them manage the mental challenges of diabetes.
She highlighted that the government has already taken steps to address this by offering free screenings, aiming to reduce the rising number of undiagnosed diabetic adults in Malaysia adding that this has been done since 2022.
Currently, the community health sectors are working with departments such as the Social Security Organisation (PERKESO) to tackle diabetes better, especially for B40 diabetic patients, so as to not deter their mental health.
Meanwhile, Dr Chooi raised concerns about the growing trend of people creating Autonomous Sensory Meridian Response (ASMR) videos of themselves eating, noting that many of these individuals are engaging in binge eating, which can quickly become a harmful habit.
“These individuals are not only at risk of developing diabetes but also face long-term psychological effects. Physically, their bodies won’t be able to keep up, and constantly associating their actions with such cravings can take a toll on their mental health,” he warned.
He called for an end to the glorification of this culture.
Additionally, Basmawati emphasised the importance of self-empowerment for diabetic patients, encouraging them to take control of their condition.
"We want diabetic patients to live with diabetes like it's nothing, to live normally like others," she said.
She said that empowering the self with the mindset that diabetes is controllable is the foremost step.
She noted that the health department is currently focusing on collaborative efforts with dietitians to promote healthy eating guidelines to the public, particularly for diabetic patients.
"We do it every month, including promoting the SMBG framework," she said.
Chua added that patients who subscribe to the SMBG framework tend to have more self-empowerment, have more control of their diabetes with the accessibility to at-home tests, more awareness of better diabetes care and the importance of regulating diet and doing more exercises.
She added that the medical staff is more than willing to provide patients with knowledge and know-how.
"It gives them real-time adjustments," she said, which are important for diabetic patients to keep their blood glucose levels stable and avoid immediate risks such as blood glucose levels becoming extremely high or low.
Jia emphasised the importance of patients addressing root causes, where the medical staff such as dietitians and doctors would empower them with corrective and preventive measures.
"It is important that you adjust your medication and are able to stabilise your diabetes for at least six months to be consistent with only self-checking after that," she said, addressing the diabetic patients.
"These all serve significant improvements for their mental wellbeing," she added.
Isolation and feelings of loneliness are common in a diabetic journey, she said, adding that regular interactions with healthcare professionals who provide consistent support can help prevent these feelings.
