Diabetes distress was first described in 1995, distinguished from other mental health challenges of depression and anxiety in 2005 and extensively measured and intervened with in research studies between 2010 and 2024. The diabetes community now has more than enough evidence to make recommendations and good practice statements to inform care for everyone living with diabetes. This clinical guideline will lead to improvements in the experience of diabetes care for millions of people worldwide, resulting in better overall health.
Professor Jackie Sturt, Professor of Behavioural Medicine and Head of the Division of Care in Long Term Conditions
17 September 2025
King's research instrumental in guiding new clinical practice guideline on diabetes distress
This has been developed for the European Association for the Study of Diabetes (EASD)
The landmark guideline will be officially presented at the EASD Annual Meeting 2025 in Vienna this week, followed by an open consultation period until 31 October 2025 after which the final guideline will be published.
Eight Good Practice Statements for the Assessment of Diabetes Distress and type 1 and type 2 diabetes will be presented which have been developed from the work of the D-stress Study. This study is led by Professor Jackie Sturt, Head of the Division of Care in Long-Term Conditions at the Faculty of Nursing, Midwifery and Palliative Care at King’s, and a member of the Guideline Development Panel for the EASD.
The two realist reviews underpinning these Good Practice Statements have been led by Professor Ruth Harris for type 1 diabetes and PhD student Megan Peck for type 2 diabetes.
The guideline was developed in line with internationally recognised standards, and crucially were co-designed with the participation of those with lived experience of types 1 and 2 diabetes.
Recognising the emotional burden of diabetes as a critical component of care, the guideline provides Good Practice Statements for routine assessment of diabetes distress and evidence-based recommendations for its management.
- Assessment: Healthcare professionals are encouraged to routinely ask about and assess diabetes distress during consultations. Good Practice Statements recommend discussing the emotional side of diabetes at every appointment, using open-ended questions, and employing valid, reliable assessment tools. Regular monitoring is advised as part of the annual cycle of care, with results recorded in clinical notes and discussed openly with the person with diabetes. When distress is identified, healthcare professionals should work together with the individual to agree on next steps, ensuring follow-up support is tailored and person-centred.
- Management: Evidence-based recommendations support the use of psychological and psychoeducational interventions to reduce diabetes distress, with specific guidance varying according to diabetes type and intervention category. While research gaps remain, the guideline underlines the value of structured support – ranging from psychological therapies to peer support and technology-based interventions – in improving emotional well-being and self-care.
The launch of this guideline marks a turning point in recognising and addressing the emotional challenges of living with diabetes. Although major advances in treatment and technology have transformed care, many people continue to experience significant emotional and psychological burden in managing the relentless demands of the condition.
Despite huge advances in therapies and technologies, the emotional burden of diabetes has not diminished – and for many, it has increased. This guideline recognises that reality, reminding us that good diabetes care must address both glucose levels and the lived experience of managing the condition. I am immensely proud to present this first EASD clinical guideline, which reflects the best available evidence and the hard work of many colleagues. It is a milestone in ensuring that emotional well-being becomes a core part of diabetes care.
Professor Chantal Mathieu, President of the European Association for the Study of Diabetes
In this story
Head of Division of Care in Long Term Conditions and Professor of Behavioural Medicine in Nursing
Professor of Health Care for Older Adults
Research Assistant & PhD Student