Adults

Among adults with childbearing potential, discuss life choices that could be affected by diabetes self-management, such as pregnancy and sexual functioning. Grade B
Providers should assess the presence of social support providers who may facilitate self-management behaviors, reduce burden of illness, and improve quality of life. Grade B


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Older adults

Annual screening for early detection of mild cognitive impairment or dementia for adults older than 65 years of age. Grade B
Assess neuropsychological function and dementia using available standards for conducting evaluations of dementia and age-related cognitive changes. Grade E
A collaborative care model, incorporating structured nurse care management intervention, is recommended for treatment of comorbid depression in older adults with diabetes. Grade A

People with diabetes complications and functional limitations

Providers should consider monitoring chronic pain associated with diabetes complications and its impact on quality of life. Pain management interventions, including referral to a behavioral health provider for pain management strategies should be provided. Grade B

Bariatric surgery

Individuals undergoing bariatric surgery should receive a comprehensive mental health assessment by a professional familiar with weight loss interventions. Grade B
Postponement of surgery should be considered if psychopathology is evident, particularly suicidal ideation or depression. Grade E
Consider assessment for need of ongoing mental health services to help patients adjust to medical and psychosocial changes post-surgery. Grade C

Reference

  1. Young-Hyman D, de Groot M, Hill-Briggs F, et al. Psychosocial care for people with diabetes: A position statement of the American Diabetes Association. Diabetes Care. 2016;39:2126-2140. doi:10.2337/dc16-2053