Clinical guideline on diabetes distress
Launched in September 2025, at the European Association for the Study of Diabetes (EASD) annual meeting in Vienna, the clinical guideline on diabetes distress represents a turning point in diabetes care. Credentialled diabetes educator and somatic (body-oriented) psychotherapist, Carolien Koreneff, explains.
What is diabetes distress?
Diabetes distress is the emotional burden and frustration of living with and managing diabetes. This can include frustrations with blood glucose levels, feeling overwhelmed, guilty, exhausted by the daily demands of self-care, or worried about complications. These feelings can affect how people manage their diabetes and their lives more broadly.
Occasionally feeling annoyed, pressured, and frustrated by the relentless, daily demands of living with diabetes is common, but when it begins to negatively impact daily life and diabetes self-care, it can potentially lead to the more severe state of diabetes burnout.
Research shows that up to 80% of people with diabetes report at least some diabetes-related problems in their daily lives, and around one in three adults with diabetes experience serious distress. This is not surprising, when you consider that people living with diabetes can make up to 180 more decisions each day about their health than someone without diabetes.
Despite major advances in therapies and technologies, many people continue to experience significant emotional and psychological burden in managing the relentless demands of this condition. Therefore, assessing and managing diabetes distress is as vital as assessing and managing glucose levels.
But until now, health professionals had no evidence-based guidance on how to identify and address diabetes distress.
Why is this guideline important?
This new guideline promotes respectful, person-centred care that meets everyone’s needs. It includes new evidence-based Good Practice Statements about the routine assessment of diabetes distress, using simple questions and validated tools. It also includes recommendations about how to manage diabetes distress.
Significantly, people living with diabetes played a key role in shaping the guideline, so it reflects real-world challenges. This is crucial as the responsibility of managing diabetes mostly lies in the hands of the person with diabetes (and their family). Awareness of the condition is there constantly, particularly when using tools such as blood glucose monitors, continuous glucose monitoring (CGM) devices and/or insulin pumps.
Most healthcare professionals now acknowledge the psychological impact of diabetes. If you feel that addressing these challenges is outside your expertise, these guidelines give you practical, evidence-based recommendations and clear pathways, bridging the gap between recognising the emotional struggles people with diabetes face on a day-to-day basis and helping them.
The guideline
This guideline is the result of a collaborative, multidisciplinary effort involving people living with diabetes, medical specialists, nurses, clinical and health psychologists, methodologists and evidence synthesis specialists, supported by the EASD Office team.
The launch marks three decades since the publication of the Problem Areas in Diabetes (PAID) scale, the first tool to assess diabetes distress. Over the past 30 years several diabetes assessment tools have been developed, validated, and translated, and there is an increasing recognition of the critical role of psychological and emotional well-being in diabetes care, self-care and outcomes.
Recognising the emotional burden of diabetes as a critical component of care, the aim of this guideline is to standardise the assessment and management of diabetes distress among adults, both with type 1 and type 2 diabetes.
This guideline addresses two domains:
- Assessment: How and when to assess diabetes distress among adults with type 1 diabetes or type 2 diabetes?
- Management: What is the effectiveness of psychological, psychoeducational, educational, peer support, and technology-based interventions for reducing diabetes distress among adults with type 1 diabetes or type 2 diabetes?
Asking about and assessing diabetes distress should be a routine part of effective, person-centred care.
The guideline represents what the evidence shows. It should guide our clinical practice and inform further research. However, listening to the person with diabetes sitting in front of (or better yet, next to) you and offering personalised support remains the bottom line.
The guideline does not cover diabetes distress among children or adolescents with type 1 or type 2 diabetes or among adults with gestational diabetes or rarer types of diabetes. Nor does it address common mental health conditions, such as depression or anxiety, which may also be relevant to consider as part of person-centred care. It does not provide detailed implementation protocols for specific interventions.
The authors
The guideline was co-led by Foundation Director of the Australian Centre for the Behavioural Research in Diabetes (ACBRD) Professor Jane Speight and Professor Richard Holt from the University of Southampton, UK. The authors are proud that their work has helped shape this global standard and they have indicated that they will support health professionals to put it into practice.
Read the full media release and access the guideline to learn more.
Reference:
Speight J, Hermanns N, Jensen W, Kanc K, Karagiannis T, Law M, Mocan A, Rutters F, Sturt J, Zaccardi F, Holt RIG. 2026 EASD evidence-based clinical practice guideline for assessing and managing diabetes distress among adults with type 1 diabetes and type 2 diabetes. European Association for the Study of Diabetes (EASD), Düsseldorf, 2026. The full guideline is freely available at www.easd.org.