Diabetes prevention focus for psychology study
Clinical psychologist and PhD researcher Sarah Malthus works with people who have serious complications of diabetes, such as amputations, kidney failure, and blindness.
She says it can be "heart-breaking" work, but it prompted her interest in developing and evaluating interventions for people at the pre-diabetes stage, so they can avoid these complications in the future.
"Diabetes is a potentially debilitating long-term health condition that comes with substantial physical and psycho-social cost, and unless more is done at a prevention level the impact on the health system is likely to be substantial," she says.
Ms Malthus, who is based at Massey University's Psychology Clinic in Palmerston North, is seeking 150 people with prediabetes who live in the MidCentral district to take part in her intervention study.
In the study, funded by the MidCentral District Health Board, participants will receive information about their condition, along with practical changes they can make to their lifestyle to reduce their risk of progressing to diabetes. Involvement requires approximately three to seven hours over six months.
People interested in the study will need to meet criteria for pre-diabetes, which is based on a blood test result. They can be referred into the study by their GP or practice nurse, or contact her directly to discuss a referral. Haemoglobin A1c (HbA1c) is the recommended screening test for Type 2 diabetes and prediabetes. Those with HbA1c levels in the range 41–49 mmol/mol are considered to have prediabetes, otherwise known as 'intermediate hyperglycaemia'.
Study participants will be randomly assigned to research groups, which will be provided with different types of lifestyle interventions relating to diet and physical activity. The interventions have been informed by international approaches in line with prediabetes advice provided by the Ministry of Health They have been developed in collaboration with the Diabetes Trust along with input from nurse practitioners, dieticians and other health professionals with extensive experience in diabetes prevention and research.
Ms Malthus said Type 2 diabetes is referred to as a 'silent killer', because in the early stages people may not have any symptoms or symptoms are very subtle. Symptoms that can indicate a shift from prediabetes to Type 2 diabetes include; feeling tired, increased thirst, increased urination, blurred vision and frequent infections.
Currently, about 25 per cent of New Zealanders meet the criteria for pre-diabetes, which means they are at high risk of developing Type 2 diabetes.
"These rising rates are partly related to changes in lifestyle, such as what we eat, our weight and how physically active we are," she says.
Rising rates of both prediabetes and diabetes within New Zealand and globally has made diabetes prevention a central focus of health research. International research has demonstrated that the risk of developing Type 2 diabetes can be substantially reduced by almost 60 per cent by providing lifestyle interventions for people with prediabetes.
Ms Malthus was motivated to pursue her doctoral research as a result of her work as a psychologist for the Massey Health Conditions Psychology Service. Her role with this service involves helping people to cope with emotional distress related to living with diabetes, and supporting them to make changes to their lifestyle to manage their diabetes.
She hopes her study will ultimately help those who are at high risk of developing diabetes take steps towards a healthier future, and prevent them from developing serious health problems down the track. She is optimistic that diabetes prevention approaches, such as these, will reduce pressure on the health system that is already overwhelmed with managing diabetes and its complications.
