News & Publications

Behavioral Health: A Foundation of Diabetes Management

Group Diabetes Education Session

by AADE | Apr 15, 2019

by Nicole Bereolos, PhD, MPH, CDEAADE Board Member Nicole Bereolos, PhD, MPH, CDE

If you asked the people living with and affected by diabetes the most challenging aspect of it, most would identify the day-to-day nuisances and the fact that it touches all areas of life. This is why behavioral health is a foundation of diabetes management. We can have the best medications and technology, but if someone is not in an emotional place to utilize those resources appropriately, then their availability will not matter. Behavioral health simply cannot be ignored, which is why it is a pillar for the vision of the specialty.

Diabetes educators will always be able to provide that human-touch to care. This is fundamental to behavioral health; it is truly person-centered. It is unrealistic to believe that diabetes educators can effectively address all aspects of behavioral health, especially given the constraints that are inevitable. There are a few things they can do to integrate behavioral health into practice.


Promoting and integrating behavioral health is not something new for the diabetes educator, but should be woven into everyday practice


Effective ways to incorporate behavioral health into clinical encounters:

  1. Ask the person with diabetes how they/their family are doing (outside the context of diabetes)
  2. Discuss potential challenges in making behavior change and problem solve ways to overcome those challenges
  3. Include important family/friends into sessions and ask for their input
  4. Specifically ask about situations that may impede self-management behavior such as finances, work, family obligations, etc.
  5. Reinforce small changes — minimize discussion points at each encounter
  6. Help to de-stigmatize a referral to a behavioral health specialist
  7. Smile, make eye contact, give 100% of your attention

This is by far not an exhaustive list, but to illustrate that you are probably already including this in your daily practice. As a clinical psychologist and CDE, I try to incorporate this by being “real” in my practice: focusing on problem-solving and balancing diabetes management with living; helping people with diabetes learn to navigate their lives without diabetes taking control and striving for them to take control; talking about what they can change versus what they cannot; exploring their health-related goals; and finally, trying to navigate how diabetes will fit the path towards meeting those goals. Therefore, promoting and integrating behavioral health is not something new for the diabetes educator, but should be woven into everyday practice.​


AADE19 – Houston on August 9-12 – will have plenty of Behavioral Health-focused sessions to choose from, including one from Keynote Speaker Michael Harris who will focus on outcomes of psychosocial/behavioral interventions that were developed to target the social determinants of health and how they impact diabetes outcomes.

More Behavioral Health Sessions:

  • Shame and Diabetes: Practicing Resilience in a Culture of Weight Stigma, Disordered Eating and Healthism will help you understand that the focus of education doesn’t always have to be on weight shaming.This session will focus on how encouraging behavior change can really impact overall health.
  • AADE’s Practical Approach to Mental Health for the Diabetes Educator which reviews AADE's new practice paper and offers clinical scenarios that aid real world implementation.
  • Beyond Coping: Raise Your Spirits, Not Your Blood Sugar which uses music to help you incorporate key methodologies to improve care in an uplifting way.
  • No One Understands Me! Helping People Live Well with Diabetes which explores helping combat the negative effects of diabetes distress in an interactive way.
  • The Weight of Change: Exploring the Impact of a Weight Neutral Approach that will put you on the frontlines of combatting weight stigma with person-centered counseling methods.
Visit AADE19.org today for access to the full schedule. Early bird registration rates available until April 26.
In This Section

News & Publications