New clinical guidelines recognise the emotional burden of diabetes as a critical component of care, with recommendations for its management
When a patient is told they have diabetes, a constant awareness begins. Regularly keeping an eye on their health and what they consume becomes a distinct part of their lives.
Understandably, this responsibility can lead to higher levels of distress among people with the disease. New evidence-based clinical practice guidelines from the European Association for the Study of Diabetes (EASD) aim to address this anxiety.
The document was developed with the assistance of people with lived experience of type 1 diabetes and type 2 diabetes, who were active members of the EASD’s Guideline Development Panel from the outset.
Their contributions helped shape the clinical questions, interpretation of evidence, and formulation of recommendations, ensuring that the final guidelines are firmly grounded in the real-world needs and priorities of adults with diabetes.
“The publication of this first EASD guideline is a landmark moment for our Association and for the international diabetes community,” said Prof. Apostolos Tsapas of the Aristotle University of Thessaloniki in Greece and Chair of the EASD Guidelines Oversight Committee.
“Assessing and managing diabetes distress is as vital as assessing and managing glucose levels – and it is this recognition that makes the present guideline so important for both clinical practice and future research to improve the lives of people with diabetes.”
Recognising the emotional burden of diabetes as a critical component of care, the guideline provides good practice statements for routine assessment of diabetes distress and evidence-based recommendations for its management.
Healthcare professionals are encouraged to routinely ask about and assess diabetes distress during consultations. Good practice statements recommend discussing the emotional side of diabetes at every appointment, using open-ended questions and using valid, reliable assessment tools.
Regular monitoring is advised as part of the annual cycle of care, with results recorded in clinical notes and discussed openly with the person with diabetes. When distress is identified, healthcare professionals should work together with the individual to agree on next steps, ensuring follow-up support is tailored and person-centred.
When it comes to managing emotional impacts, evidence-based recommendations support the use of psychological and psychoeducational interventions to reduce diabetes distress, with specific guidance varying according to diabetes type and intervention category.
While research gaps remain, the guideline underlines the value of structured support – ranging from psychological therapies to peer support and technology-based interventions – in improving emotional well-being and self-care.
The guidelines were presented at the EASD Annual Meeting 2025 in September. This was followed by an open consultation period until October 31, with the final guidelines expected to be published shortly.
“Despite huge advances in therapies and technologies, the emotional burden of diabetes has not diminished – and for many, it has increased,” said EASD president Prof. Chantal Mathieu.
“This guideline recognises that reality, reminding us that good diabetes care must address both glucose levels, and the lived experience of managing the condition.
“I am immensely proud to present this first EASD clinical guideline, which reflects the best available evidence and the hard work of many colleagues. It is a milestone in ensuring that emotional well-being becomes a core part of diabetes care.”
The EASD advises that successful implementation of the guideline will require training, system-level support, and integration into routine care.
The organisation plans to support dissemination through peer-reviewed publication, open-access availability, and plain-language summaries designed for accessibility by people living with diabetes and the wider public.
Prof. Jane Speight of the Australian Centre for Behavioural Research in Diabetes and co-chair of the Guideline Development Panel, said: “We hope that this guideline will empower healthcare professionals to routinely assess and address the emotional burden of living with diabetes, ultimately improving outcomes for adults with type 1 and type 2 diabetes across Europe and beyond.”
Previous studies have found that people with diabetes have a higher risk of developing depression. An evidence review exploring the relationship between the two conditions, published in the journal Translational Psychiatry earlier this year, found that clinical approaches focused on either condition in isolation fall short of addressing the intertwined nature of diabetes and depression.
“Instead, integrated care models encompassing psychological support and medical management are recommended to improve treatment efficacy and patient adherence,” the review states.
“Such models require collaboration across multiple healthcare disciplines, including endocrinology, psychiatry, and primary care, to offer a holistic approach to patient care.”
The review also found that issues such as stigma, psychological resistance, and health literacy can act as barriers to effective management of these conditions.
However, these problems can be addressed through patient-centered education and support systems.
The paper’s authors stress that further studies are needed to understand the causal pathways linking depression and diabetes. Future research should also focus on personalised medicine, considering genetic, environmental and lifestyle factors that influence both conditions, the authors added.
“Exploring novel therapeutic targets like the repurposing of anti-inflammatory and antidiabetic agents could revolutionize treatment approaches in patients suffering from both depression and diabetes,” the review concludes.
“Additionally, the impact of emerging technologies such as digital health tools and telemedicine on patient outcomes and care delivery needs further investigation to enhance care accessibility and cost-effectiveness in diverse settings.” 
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