Online Cognitive Behavioral Therapy Benefiting Diabetes Patients with Depression

A study shows that patients who received online cognitive behavioral therapy tailored for patients with diabetes reported improvements in depression and anxiety, which resulted in better diabetes management.
Updated: June 14th, 2022
Linda Maxwell

Contributor

Linda Maxwell

There are 422 million people with diabetes worldwide. In the United States, there are 34.2 million people, or 10.5% of the U.S. population, with diabetes. Almost two million (1.8 million) Australians, 2.4 million Canadians, and more than 4.9 million people in the United Kingdom live with diabetes.  

According to the Mayo Clinic, diabetes can cause complications and health problems that may worsen symptoms of depression. If you have diabetes — either type 1 or type 2 — you have an increased risk of developing depression. And if you're depressed, you may have a greater chance of developing type 2 diabetes. Those with depression often have poor lifestyle decisions. Unhealthy eating, less exercise, smoking, and weight gain are risk factors for diabetes.

Quality of Life Concerns with Diabetes

Both diabetes and depression reduce the quality of life for an individual, but together they have a more negative impact on overall health and well-being. Complications of diabetes lead to a higher risk of needing long-term health care. Combined with depression, it combination makes aging more difficult. 

Having diabetes can result in nerve damage and ongoing pain, vision loss, kidney dysfunction, memory changes, urinary incontinence, or slow-healing wounds. It increases the risk of falls, and falls are a leading reason for emergency room visits and long-term health care.

A research study commissioned by the British company ieso reported that integrated mental health care in diabetes patients can improve mental health outcomes, patient engagement with self-management of diabetes, diabetes distress, and quality of life.  

Cognitive Behavioral Therapy Alleviates Depression

Results of the study were presented at the 2022 American Diabetes Association (ADA) Annual Conference. Patients who received ieso's online cognitive behavioral therapy, tailored for patients with Type 2 diabetes, reported improvements in depression and anxiety, which resulted in better diabetes management.

Patients also reported reduced distress levels about their diabetes, increased engagement in managing their condition, and improved quality of life.

Online Cognitive Behavioral Therapy (CBT) focuses on thoughts, beliefs, and behaviors. CBT helps an individual unlearn undesired reactions and replace them with healthy reactions. CBT therapy online is known for providing many long-term, positive results.

Comorbid Mental Health Problems Significant with Diabetics 

About 25% of patients with diabetes have comorbid depression, and 40% have comorbid anxiety. Comorbid mental health problems in patients with diabetes are associated with poorer quality of life, poorer diabetes management, and even decreased lifespan. 

It is estimated that comorbid physical and mental health conditions increase physical health care costs by 45% to 75% and that tailored interventions are associated with substantial savings in health care costs.

Feelings of being low in mood or worry can have a significant impact on a patient's ability to manage their diabetes. We've now shown that addressing these feelings with tailored online therapy can improve a patient's physical and emotional well-being.

Andy Blackwell, Chief Science and Strategy Officer at ieso

Diabetes-specific online cognitive behavioral therapy is shown to improve outcomes in Type 2 diabetics.

These results have much wider implications for the role of digital CBT therapy, mental health and its impact on clinical outcomes across a variety of different healthcare conditions. New online tools are needed to improve patient access to quality mental health care, which can significantly impact clinical outcomes and associated costs in chronic diseases such as diabetes.

Andy Richards, Chairmen at ieso

Strokes, Dementia, and Diabetes 

Diabetes is a significant health concern. Diabetes makes it more likely that plaque develops in blood vessels, leading to a higher risk of strokes and dementia. All of these health problems get more problematic as a person gets older. 

According to the American Association for Long-Term Care Insurance (AALTCI), adults with diabetes face a significantly higher risk of developing dementia, including Alzheimer's disease, the leading cause of Long-Term Care Insurance claims.

Jesse Slome, the executive director of the AALCTI, says the number of people with diabetes is considerable, but another 79 million have pre-diabetes

Obesity increases the risk of diabetes, and as Americans become heavier, more are developing diabetes and thus will be at greater risk of needing costly long-term care.

-Jesse Slome

An estimated 18% of patients in long-term health care facilities have diabetes, and the cost of care is higher for those with complications and mobility and cognitive issues associated with diabetes. 

Long-Term Health Care Costs Higher for Diabetics with Complications

Long-term health care costs are skyrocketing worldwide. In the United States, the average cost of a nursing home is over $100,000 a year, according to the LTC NEWS Cost of Care Calculator

In-home care, adult day care centers, and assisted living facilities cost less, but those costs are also rising sharply due to increased demand for care, inflation, and higher labor costs. Most long-term health care is delivered outside of a nursing home, but the financial impact is still considerable. 

Often untrained and unprepared family members, typically a daughter or daughter-in-law, become caregivers. These family caregivers attempt to juggle their careers and families with their role as a caregiver. The outcome for both the care recipient and the caregiver is not usually good as the health and well-being of both decreases.

LTC Costs Not Covered by Health Insurance or Medicare

Traditional health insurance and Medicare in the U.S. will not pay for most long-term health care costs. Medicaid will pay for long-term health care, usually in a Medicaid nursing home, but the care recipient must have little or no income and assets to qualify for the benefits. 

Access to quality care options, especially in someone's home, is more desirable for most care recipients and families. Long-Term Care Insurance will pay for these options, but you must have coverage in place before declining health.

Those with diabetes can get Long-Term Care Insurance, but it must be in control with no complications. Every insurance company has its own underwriting rules concerning diabetes. Most people obtain coverage in their 50s before these health problems make it more difficult or costly to get a policy, or in some cases, impossible. 

Continued advances in diabetes treatment, including addressing comorbidities like depression, will benefit the quality of life for these people. Being proactive with your health can help a person avoid developing diabetes in the first place. For those already with the disease, better manage it with fewer complications. 

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