- A new diabetes psychology pathway in Wales aims to give people faster access to mental health support designed specifically around living with diabetes.
- The move follows growing concern that people with diabetes are often bounced between physical health and mental health services, with neither properly set up to deal with both together.
- Campaigners and clinicians say the new model could fill a major gap in care, especially for people struggling with burnout, depression, OCD or insulin omission.
A new specialist mental health pathway for people with diabetes is being developed in Wales, in what experts say is a UK first.
The aim is to offer more joined-up support for people whose mental health and diabetes management are closely tied together.
For many patients, that gap in care has been a serious problem.
Naomi Durham, from Cardiff, said severe post-natal depression after the birth of her second daughter left her feeling numb and hopeless.
At her lowest point, she stopped taking the insulin she needed for her type 1 diabetes.
That led to repeated admissions to hospital with diabetic ketoacidosis, a life-threatening complication caused by a lack of insulin.
She said she felt caught between two systems.
The diabetes team treated it as a mental health issue, while mental health services treated it as a diabetes issue.
In practice, that meant she did not feel properly supported by either.
Naomi said peer support groups, online communities and charity services ended up helping more than formal services at the time.
But she still believes people in her position need better holistic assessment and clearer routes into the right help.
Poet Duke Al described a different but related experience.
After being diagnosed with type 1 diabetes, he said the condition collided badly with his existing OCD.
At times, intrusive thoughts around numbers led him to inject the wrong amount of insulin or avoid injecting altogether.
He said diabetes burnout and the constant demand of managing blood sugar, insulin, food and exercise became overwhelming.
Although he now feels in a much better place, he said there was not a huge amount of mental health support available that really understood diabetes.
That lack of joined-up care is exactly what the new pathway is supposed to address.
Dr Rose Stewart, diabetes psychology lead for Wales, said diabetes is relentless and can have a huge psychological impact.
She said many people feel as if they are being asked to do the work of their own pancreas around the clock, without ever getting a break.
Her team is developing a national model of care that would give people in Wales quicker access to specialist support in different formats.
That could include online help, one-to-one therapy and crisis care, as well as training for diabetes staff so they are better equipped to deal with psychological distress.
The broader point is straightforward.
You can have a good HbA1c and still be struggling badly.
Equally, poor diabetes management is not always just about knowledge or motivation – sometimes it is bound up with depression, burnout, fear, trauma or obsessive thinking.
This new pathway matters because it treats the person as a whole, rather than trying to split physical health from mental health when, for many people with diabetes, the two are inseparable.
