Psychologische Herausforderungen bei Erwachsenen mit Typ-1-Diabetes

Zusammenfassung

Menschen mit Typ-1-Diabetes müssen immer wieder verschiedene Anpassungsleistungen erbringen, um ihre Erkrankung und deren Therapie in den Alltag integrieren zu können. Gelingt dies nicht, können daraus Probleme beim Selbstmanagement der Krankheit resultieren. Doch trotz strukturierter Schulungsprogramme und leitliniengerechter, individuell zugeschnittener Therapieempfehlungen leben einige Menschen mit Typ-1-Diabetes mit chronisch erhöhten Blutzuckerwerten. Dabei scheint der Diabetes-Distress als Reaktion auf die erlebten Herausforderungen eine wichtige Rolle zu spielen und im Zusammenhang mit Problemen bei der glykämischen Kontrolle wie auch einer Therapievermeidung zu stehen. Um eine Chronifizierung des Diabetes-Distress zu verhindern, empfiehlt es sich daher, ein Screening auf diabetesbezogene Belastungen in der Versorgung von Menschen mit Typ-1-Diabetes zu etablieren. Dies kann mittels Fragebogen oder der Thematisierung im persönlichen Gespräch geschehen. Diabetesspezifische psychologische Interventionen können sowohl die diabetesbezogene emotionale Belastung als auch die glykämische Kontrolle verbessern, sind jedoch in Deutschland noch nicht in der Regelversorgung verfügbar.

Abstract

People with Type 1 Diabetes are continuously forced to adapt in different ways to integrate the demands of their illness and its therapy into their daily life. A lack of resolution in these psychological challenges can result in problems with self-management. Some people with type 1 diabetes live with chronically elevated blood glucose values despite having had the benefit of well-structured diabetes education programmes and individually tailored guideline-oriented therapy recommendations. As a reaction to the challenges experienced by people with type 1 diabetes, diabetes distress appears to play an important role and is related to problems with glycaemic control and avoidance of therapy. For this reason, in order to prevent the development of chronic distress, the establishment of regular screening for diabetes specific burdens – be it by questionnaire or as part of the clinical conversation – is recommended. Diabetes-specific psychological interventions can reduce diabetes-specific emotional distress as well as glycaemic control but are not currently available in Germany as part of standard care.

Schlüsselwörter

Diabetes - Distress - Adhärenz - Motivation

Key words

diabetes - distress - adherence - motivation

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