Managing patients with diabetes mellitus and mental health problems - Administrative and clinical challenges

Diabetes mellitus is the subject of a great many case management programs a round the world as it is a prevalent disease with modifiable risk factors a nd potentially preventable severely disabling complications. Diabetes melli tus represents even greater challenges in the context of mental illness. Pa tients with psychological complications of diabetes mellitus or with psychi atric disease and comorbid diabetes mellitus present a unique set of proble ms with which the physician and other care providers must contend. These ch allenges include: problems with treatment regimens; inability to manage sel f-care programs; difficulties with negotiating appointments, referrals, and follow-up care; confusion over competing care instructions; potential drug interactions and/or complications which exacerbate diabetes mellitus; and many social difficulties which undermine the effective care of diabetes mel litus. Lack of control of either diabetes mellitus or mental health problems may c omplicate or exacerbate one or the other of these diseases. Case management for these individuals is one potential way of improving care. Management n eeds to be team based, coordinated between specialties, simplified, and in one location of care when possible. Excellent coordination and communicatio n is paramount and social factors and supports require special attention.