Indian and American Guidance on Psychosocial Care of Persons with Diabetes.

Sir,

The American Diabetes Association (ADA) has recently published its position statement on psychosocial care of people with diabetes.[1] As per their acknowledgment, the authors mention that the process of preparing this document began a decade ago, in 2006–2007. This long journey highlights the efforts it has taken for researchers to get psychosocial care accepted as an integral part of diabetes management.

India has a relatively shorter history of modern diabetes care. In contrast to the ADA, which was founded in 1940, the Research Society for Study of Diabetes in India turns 45 this year (2017).[23] Similarly, The Endocrine Society of USA began a 100 years ago, while the Endocrine Society of India was formed in 1971.[45] Yet,[6] India was able to publish National Recommendations on Psychosocial Management of Diabetes in 2013. Written by 13 authors from multiple specialties (endocrinology/diabetology, psychiatry, psychology and community medicine), this comprehensive document covers a wide spectrum of psychological, psychiatric and social issues, and lists 94 specific recommendations. The Indian guidelines describe means of improving skills of health-care professional and awareness of patients as well as the community at large. A detailed description of how to assess and manage psychological, psychiatric, and social challenges is provided. Indian acronyms to explain the attributes of a good diabetes care provider (CARES)[7] and motivational interviewing (WATER)[8] are highlighted. Indigenous forms of treatment or support, such as yoga, meditation, and folk dance therapy, are suggested.

While the national guidelines do not mention the phrase “life course considerations,” they do focus on unique psychosocial needs (and solutions for) children and adolescents, poor socioeconomic class, rural-dwellers, and women. The contribution of family, custom/religion, and community, in achieving effective diabetes care is stressed upon.

The ADA position statement will be taken as a landmark in comprehensive diabetes care. The Indian recommendations on psychosocial management are an equally robust and relevant contribution to psychosocial care and should be acknowledged as such.

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Conflicts of interest

There are no conflicts of interest.