Diabetes and mental health
Diabetes and mental health
This Review summarises the research into five common mental health problems that can affect adults living with type 1 diabetes, type 2 diabetes, or gestational diabetes: fear of hypoglycaemia, diabetes distress, depression, disordered eating, and sleep disorders. Mental health problems are common among adults with diabetes and can substantially decrease the quality of life and self-care, and increase the risk of adverse health outcomes, such as high HbA1c, comorbidities, and premature mortality. Many mental health problems are bi-directionally linked to diabetes. Randomised controlled trials have shown that psychological interventions are effective in reducing symptoms in the short term, including cognitive behavioural therapy, mindfulness-based cognitive therapy, and stepped care, which can also be offered digitally as a first step. However, diabetes distress, depression, and other mental health problems are known to recur and the longer-term outcomes of prevention or treatments are unclear. In general, mental health problems are understudied in diabetes, particularly gestational diabetes. People with diabetes want to talk with their diabetes health professionals about the emotional side of living with and managing diabetes. These findings support the integration of routine monitoring and psychological support into clinical practice. Health-care policy makers should ensure that diabetes health-care professionals are well equipped to discuss mental health and refer to appropriate digital health tools and mental health specialists when needed.
337-355
Pouwer, François
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Ehrmann, Dominic
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Strandberg, Ragnhild Bjarkøy
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Ismail, Khalida
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Aalders, Jori
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Rutters, Femke
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de Wit, Maartje
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Speight, Jane
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Iversen, Marjolein
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Holt, Richard I.G.
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1 April 2026
Pouwer, François
71792d2d-7440-4277-a3c7-dc641ef3f0aa
Ehrmann, Dominic
f49cb0fb-5a90-4794-ac21-b5db9926a9bc
Strandberg, Ragnhild Bjarkøy
806bee10-5a95-4eaf-ba8d-949e6f29adb0
Ismail, Khalida
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Aalders, Jori
5df16c4d-fa5b-4e5d-ba34-b88dfcca8ce1
Rutters, Femke
030bdd43-90a8-47f1-bb3a-8fc1d23fc472
de Wit, Maartje
810d953e-6861-4944-96ec-a15034c39cba
Speight, Jane
b7f86c5b-4aea-4943-bddf-b9e5693e38f1
Iversen, Marjolein
d4a17fd1-2827-41f0-bf50-565f184a65ec
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Pouwer, François, Ehrmann, Dominic, Strandberg, Ragnhild Bjarkøy, Ismail, Khalida, Aalders, Jori, Rutters, Femke, de Wit, Maartje, Speight, Jane, Iversen, Marjolein and Holt, Richard I.G.
(2026)
Diabetes and mental health.
The Lancet Diabetes & Endocrinology, 14 (4), .
(doi:10.1016/S2213-8587(25)00397-3).
Abstract
This Review summarises the research into five common mental health problems that can affect adults living with type 1 diabetes, type 2 diabetes, or gestational diabetes: fear of hypoglycaemia, diabetes distress, depression, disordered eating, and sleep disorders. Mental health problems are common among adults with diabetes and can substantially decrease the quality of life and self-care, and increase the risk of adverse health outcomes, such as high HbA1c, comorbidities, and premature mortality. Many mental health problems are bi-directionally linked to diabetes. Randomised controlled trials have shown that psychological interventions are effective in reducing symptoms in the short term, including cognitive behavioural therapy, mindfulness-based cognitive therapy, and stepped care, which can also be offered digitally as a first step. However, diabetes distress, depression, and other mental health problems are known to recur and the longer-term outcomes of prevention or treatments are unclear. In general, mental health problems are understudied in diabetes, particularly gestational diabetes. People with diabetes want to talk with their diabetes health professionals about the emotional side of living with and managing diabetes. These findings support the integration of routine monitoring and psychological support into clinical practice. Health-care policy makers should ensure that diabetes health-care professionals are well equipped to discuss mental health and refer to appropriate digital health tools and mental health specialists when needed.
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Accepted/In Press date: 8 December 2025
e-pub ahead of print date: 20 February 2026
Published date: 1 April 2026
Identifiers
Local EPrints ID: 509539
URI: http://eprints.soton.ac.uk/id/eprint/509539
ISSN: 2213-8587
PURE UUID: 000d9620-3c36-4e96-891c-5426ea6738ff
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Date deposited: 25 Feb 2026 17:43
Last modified: 21 Apr 2026 01:37
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Contributors
Author:
François Pouwer
Author:
Dominic Ehrmann
Author:
Ragnhild Bjarkøy Strandberg
Author:
Khalida Ismail
Author:
Jori Aalders
Author:
Femke Rutters
Author:
Maartje de Wit
Author:
Jane Speight
Author:
Marjolein Iversen
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