Management of mental illness in patients with diabetes

Patients who have diabetes commonly have mood, anxiety, and psychotic disorders. These disorders may have multiple biologic underpinnings. Without treatment, care becomes complicated and outcomes are poor. Early diagnosis and biopsychosocial treatment that integrates medical and psychiatric interventions is highly desirable. Medications have a major role in treatment, although caution must be exercised because of potential side effects. Psychiatric consultation or management may be required for urgent or severe cases. An appreciation of culture, both ethnic and beyond, is a foundation for enhancing physician-patient relations and developing realistic expectations for treatment.