For the 300,000 Canadians living with type 1 diabetes (T1D), each day brings challenges – challenges that many others don’t understand. People living with T1D must follow a strict lifelong treatment plan that includes constant blood sugar monitoring, counting carbohydrates and taking insulin multiple times a day to stay alive. Due to this heavy burden of self-management and other factors such a social stigma, people living with type 1 diabetes are more likely to experience mental health challenges than their peers without T1D.
However, there are currently many gaps in knowledge, the healthcare system, and community support that mean this critical aspect of diabetes management is often overlooked. This is why JDRF Canada is pleased to announce that it has launched a $2 million fundraising campaign exclusively to support of the development of its first mental health strategy.
2021 marks the 100th anniversary of the discovery of insulin in Canada. Earlier this year, in honour of this anniversary, JDRF Canada, the largest charitable funder of T1D research in Canada, launched its $100M Campaign to Accelerate to build upon a long legacy of outstanding Canadian diabetes research, accelerating towards cures and improving the lives of those living with T1D. The Campaign takes a six pillar approach towards aggressively funding research into cures, while also helping people with T1D live healthier lives now – and given the importance of mental health in T1D, it is the focus of one of the Campaign’s pillars.
T1D never takes a day off, and constant and continual management coupled with worries about diabetes-related complications can take a toll on mental and emotional health. Compared to those without the condition, those with diabetes are more likely to experience depression or develop an eating disorder,1-3 and one in five youth with T1D suffer from anxiety.4
Why we are launching a Mental Health Strategy
“I’m okay, but I’m not happy. We’ve figured things out – mostly – after ten long years. Diabetes takes a lot out of me, emotionally and physically, and gets in my way every single day. I’ve cried a lot, and I’ve gotten frustrated, and sad, and angry. Diabetes takes up a lot of my emotional bandwidth and I’m tired of it…Diabetes makes me feel inadequate, but I’m doing my best.”
Maryna Ell, a young adult who lives with T1D
Despite mental health being a crucial component of holistic diabetes management, it is often overlooked in diabetes care. Routine diabetes appointments frequently focus on the urgent aspects of diabetes care such as glucose-management and lack time to address emotional wellbeing and mental health. On top of this, there are only a handful of mental health care providers in Canada who specialize in the needs of the diabetes community.
There is currently no standard pathway for identification, screening and referral of mental health concerns for people with T1D. Finally, research in the area of mental health and T1D is woefully under-funded.
“Mental health challenges together represent one of the most pervasive health issues affecting Canadians today. When you add a chronic condition like T1D, feelings of anxiety, stress and depression are often amplified, which can negatively affect physical health. With a clear indication of the mental health strain this disease has on people living with T1D and the obvious gaps in care, it’s time to take action and that’s why we are raising $2M and launching our first mental health strategy.”
Dr. Sarah Linklater, Chief Scientific Officer of JDRF Canada
Our plans to address the need
“Mental health needs to be a larger part of care, especially for teens with diabetes. There is so much pressure socially, academically and hormonally and it’s hard to find anyone who understands the difficulty of managing diabetes on top of all of that.”
Jenna, JDRF Youth Ambassador, diagnosed with T1D at age 12
The vision of JDRF Canada’s Mental Health Strategy is to expand and create new avenues for children, youth, and adults with diabetes to access psychosocial health support and mental health services, ultimately improving quality of life and health outcomes.
The Strategy will involve multiple initiatives that focus in three main areas: funding research on mental health and T1D, informing and educating health care providers, and developing new programs to support the T1D community. Several initiatives, including research funding opportunities and development of a new virtual training program about diabetes for registered Canadian mental health providers, are already in progress.
“I started providing psychological services to those living with diabetes in 1985. At that time, I was amongst only a few Canadian mental health providers with an expertise in diabetes. Thirty-five years later almost nothing has changed. Most people living with diabetes experience psychosocial challenges that negatively impact their health and quality of life. Psychosocial issues are amongst the biggest care gap in diabetes management.”
Dr. Michael Vallis, registered psychologist and Associate Professor, Family Medicine, Dalhousie University, Halifax, NS
With the help of donors and our initial partners including Brain Canada, BD, iA Financial Group, Canucks for Kids and The Leona M. and Harry B. Helmsley Charitable Trust, JDRF is well-positioned to take the lead to address gaps in care and tackle one of the most significant health issues facing Canadians with diabetes.
With further support from donors and partners, JDRF can help to provide a unified approach to helping families across Canada overcome challenges and cope with T1D.
Facts and figures
People living with T1D are more likely to experience mental health disorders compared with their peers without T1D:
- The prevalence of depression is 3 times higher in people with T1D than people without diabetes, with women experiencing higher rates than men.1
- Teenage girls with T1D are 2.4 times more likely to develop an eating disorder, and over 30% of women with T1D have been reported to restrict insulin to control weight.2,3
- One in five youth with T1D experience anxiety.4
- Half of adults with T1D experience “diabetes distress”, a clinical term to describe the powerlessness, stress, guilt, relentless worry and denial that comes with living with diabetes and the burden of self-management.5
- Mental health issues in people with diabetes are correlated with worse outcomes, including worse glycemic control,6-9 more frequent and severe hypoglycemia,10 and more frequent diabetic ketoacidosis (DKA),6 increased frequency of diabetes complications.11
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To learn more about partnering with JDRF Canada and get more details about our Mental Health Strategy, or to share your story about the impact of T1D on your psychosocial health and emotional wellbeing, please contact us at mentalhealthstrategy@jdrf.ca
References
1) Roy T and Lloyd CE. Epidemiology of depression and diabetes: a systematic review. Journal of Affective Disorders. 2012. 142 Suppl: S8-21.
2) Goebel-Fabbri, A. Diabetes and Eating Disorders. J Diabetes Sci Technol. 2008. May; 2: 530–532.
3) Hanlan ME et al. Eating Disorders and Disordered Eating in Type 1 Diabetes: Prevalence, Screening, and Treatment Options. Curr Diab Rep. 2013. Sep 12:10.1007/s11892-013-0418-4.
4) Herzer M and Hood KK. Anxiety Symptoms in Adolescents with Type 1 Diabetes: Association with Blood Glucose Monitoring and Glycemic Control. J Pediatric Psychol. 2010. May; 35: 415–425.
5) Vallis M et al. Diabetes Attitudes, Wishes and Needs Second Study (DAWN2): Understanding Diabetes-Related Psychosocial Outcomes for Canadians with Diabetes. Can J Diabetes. 2016. Jun; 40:bv234-41.
6) Plener PL et al. Depression, metabolic control, and antidepressant medication in young patients with type 1 diabetes. Pediatric Diabetes 2015; 16: 58–66.
7) Corathers SD et al. Improving depression screening for adolescents with type 1 diabetes. Pediatrics. 2013. 132:e1395-402.
8) Lustman PJ et al. Depression and poor glycemic control: a meta-analytic review of the literature. Diabetes Care 2000. 23:934–942.
9) Strandberg RB et al. Longitudinal relationship between diabetes-specific emotional distress and follow-up HbA1c in adults with Type 1 diabetes mellitus. Diabetic Medicine. 2015. 32: 1304-10.
10) Katon WJ et al. Association of depression with increased risk of severe hypoglycemic episodes in patients with diabetes. Annals of Family Medicine. 2013. 11: 245-50.
11) de Groot M et al. Association of depression and diabetes complications: a meta-analysis. Psychosomatic Medicine 2001. 63: 619–630.
