Quality Standards for Diabetes Care Toolkit

Implementation advice

In everyday practice

If problems are identified, there are options depending on the need:

follow up with the nurse or medical practitioner

referral via primary or secondary care mental health services or local psychology services

an Employee Assistance Programme (EAP) if they are working and have this available to them

online therapies eg, Beating the Blues, depression.org (see Resources section).
The Scottish Intercollegiate Guidelines Network (SIGN) Guidelines have provided the following checklist for the provision of information in daily clinical practice. This gives examples of the information patients/carers/family/whānau may find helpful at the key stages of the patient journey. The checklist was designed by members of the SIGN guideline development group based on their experience and their understanding of the evidence base. The checklist is neither exhaustive nor exclusive.
Health care professionals should:

on those occasions where significant psychosocial problems are identified, explain the link between these and poorer diabetes control. If possible, it is good practice to also give suitable leaflets. They should advise patients where best to obtain further help, and facilitate this if appropriate

be mindful of the burden caused by psychosocial problems (such as clinical and subclinical levels of depression) when setting goals and adjusting complex treatment regimens (typically adults and children will be less able to make substantial changes to their lives during difficult times).
People with diabetes (or parents/guardians) should:

try to speak to their general practitioner or diabetes team if they feel they (or their children) have significant psychosocial issues

be mindful that many psychosocial problems make diabetes self-care more difficult and also that many difficulties can be successfully treated with the right help.