Treatment pathways for patients with uncontrolled diabetes and probable diabetes distress
- 1Oregon Health and Science University
Abstract
Diabetes distress (DD) has a major impact on both diabetes control and emotional well-being but is mis- and underdiagnosed and undertreated. Treatment often starts with behavioral health (BH) through counseling or medications; in some patients, Certified Diabetes Care and Education Specialists (CDCES) are proven to better manage treatment burden and address distress. We performed an observational study comparing outcomes for people with high emotional distress (PHQ9 or GAD7 > 10) and high A1c 8.0 at baseline with CDCES support, BH treatment, both or neither. Results demonstrate both CDCES and behavioral health treatment were most effective (A1c -1.2%, PHQ -3.1) but received in only 4.3% of patients, while 50% of patients received BH treatment alone. Conclusion is that these services remain valuable in routine practice but are underutilized. Workflows that assist in CDCES treatment for patients at risk could improve outcomes.
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BibTeX
@misc{dorr2026treatment,
title = {{Treatment pathways for patients with uncontrolled diabetes and probable diabetes distress}},
author = {D. A. Dorr and K. D. Peak and E. Young and L. Michaels and R. Tweet and D. Hessler Jones},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.16.26363258},
url = {https://www.medrxiv.org/content/10.64898/2026.09.16.26363258v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Treatment pathways for patients with uncontrolled diabetes and probable diabetes distress
AU - D. A. Dorr
AU - K. D. Peak
AU - E. Young
AU - L. Michaels
AU - R. Tweet
AU - D. Hessler Jones
PY - 2026
DA - 2026/09/16
PB - medRxiv
DO - 10.64898/2026.09.16.26363258
UR - https://www.medrxiv.org/content/10.64898/2026.09.16.26363258v1
AB - Diabetes distress (DD) has a major impact on both diabetes control and emotional well-being but is mis- and underdiagnosed and undertreated. Treatment often starts with behavioral health (BH) through counseling or medications; in some patients, Certified Diabetes Care and Education Specialists (CDCES) are proven to better manage treatment burden and address distress. We performed an observational study comparing outcomes for people with high emotional distress (PHQ9 or GAD7 > 10) and high A1c 8.0 at baseline with CDCES support, BH treatment, both or neither. Results demonstrate both CDCES and behavioral health treatment were most effective (A1c -1.2%, PHQ -3.1) but received in only 4.3% of patients, while 50% of patients received BH treatment alone. Conclusion is that these services remain valuable in routine practice but are underutilized. Workflows that assist in CDCES treatment for patients at risk could improve outcomes.
ER -