Integrating Behavioral Health Care and Diabetes Management

1. Depression and anxiety can complicate management of diabetes for which of the following reasons:

a) Symptoms overlap with hypoglycemia.
b) Anxiety about injections/blood draws may trigger panic symptoms.
c) Fear of hypoglycemia may lead patients to purposely keep glucose levels above target levels.
d) Stress hormones contribute to glucose fluctuations.
e) All of the above.

2. People living with diabetes (both Type 1 and Type 2) are at increased risk for depression, anxiety, and eating disorders and should be screened regularly.

a) True
b) False

3. Behavioral health conditions make diabetes management challenging and difficult to adhere to which of the following treatment plans:

a) Medication use
b) Physical activity
c) Dietary
d) Blood sugar monitoring
e) Inconsistent follow up with providers
f) All of the above.

4. Which of the following are possible barriers to integrated behavioral health:

a) A shortage of behavioral health providers trained to deliver lifestyle interventions tailored specifically for individuals with diabetes
b) Reimbursement issues
c) Patient engagement
d) Provider engagement/acceptance of the integrated model of care
e) All of the above.

5. Which of the following are arguments for taking a family approach to Diabetes Management:

a) Much of the Diabetes Management relies upon lifestyle changes that involve family members, particularly diet and exercise.
b) Emotional reactions to having a serious chronic disease affect patients and families alike.
c) Diabetes Management may alter family roles and power relations.
d) Symptoms may interfere with harmonious family functioning.
e) Conflicts and communication difficulties may result from the illness demands.
f) All of the above.

6. Only 25-50% of people with depression are diagnosed and treated. Symptoms of depression may include which of the following

a) Depressed mood most of the day
b) Reduced interest/pleasure in all/almost all activities
c) Marked weight loss/gain
d) Sleep disorders
e) Psychomotor agitation/ retardation
f) Fatigue or loss of energy
g) Feelings of worthlessness or guilt (excessive/inappropriate)
h) Problems concentrating or indecisiveness
i) Recurrent thoughts of death, SI or suicide attempt
j) All of the above.

7. According to the ADA Standards of Medical Care in Diabetes-2016/2018, psychosocial care should be integrated with a collaborative, patient-centered approach and provided to all people with diabetes, with the goals of optimizing health outcomes and health-related quality of life.

a) True
b) False

8. Motivational Interviewing and Patient and Family Engagement techniques can be helpful components of diabetes management and behavioral health treatment strategy.

a) True
b) False