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Behavioral & Mental Health

Improving Health and Lives

Diabetes has a significant impact on people’s lives. Both type 1 and type 2 diabetes are chronic diseases, requiring adjustments in diet and careful monitoring of activity levels, while adding pressures on personal relations and family life. Researchers in the Section on Behavioral and Mental Health are conducting clinical studies to determine how psychosocial and behavioral factors affect long-term health outcomes and overall quality of life in people with diabetes.
Clinical studies encompass the myriad aspects of living with diabetes and range from assessments of individuals to interventions applied in group settings. The section emphasizes translational and outcomes studies, so that promising concepts and educational interventions can move from the research setting into clinical practice. The ultimate goal of the section’s research activities is to translate behavioral and mental health science results into practical clinical programs.

Diabetes and the Brain

It has long been recognized that diabetes, like other chronic diseases, causes emotional reactions that can affect treatment and health outcomes. Researchers in the section strive not only to better understand the wide variety of mental health consequences of diabetes, but also to determine how psychological and social factors contribute to development of medical complications. Current areas of research, for instance, include an evaluation of the emotional components involved in obesity, looking at factors that both contribute to and result from this condition. Other researchers are assessing the impact of diabetes on depression and eating disorders.
Particularly intriguing is a new line of research investigating the neuropsychiatric impact of diabetes. Increasing evidence suggests that diabetes is associated with the development of mood disorders such as depression, as well as decreased cognitive function and changes in brain structure. Using advanced imaging techniques such as structural and functional magnetic resonance imaging (MRI), researchers in the section are trying to better understand the mechanisms in diabetes that may result in changes in the central nervous system.

Improving Outcomes

To develop better educational and behavioral interventions aimed at improving the health outcomes of people with diabetes, researchers in the section collaborate with both adult and pediatric clinicians at Joslin and other institutions. One senior investigator, for instance, is the director of Joslin’s Center for Innovation in Diabetes Education. This strong connection between the research and clinical arenas of behavioral and mental health has helped to speed the implementation and evaluation of individual and group-based programs aimed at improving self-care behaviors and assessing outcomes of patients with diabetes.
Another significant collaboration is with the Joslin Clinic’s Pediatric, Adolescent and Young Adult  Section; this partnership resulted in the development of the Care Ambassador Program, which provides outreach to families. Children who receive Care Ambassador support services are more than three times as likely to improve their blood glucose levels as children who receive standard multidisciplinary care.
The section also participates in the multi-center Epidemiology of Diabetes Interventions and Complications (EDIC) study, a follow-up to the landmark Diabetes Control and Complications Trial (DCCT), which documented significant health benefits of close control of blood glucose levels. Section researchers not only are examining the impact of tight control on long-term vascular complications, but also are assessing the impact on cognitive functioning.
In the near future, the section plans to establish an eating disorder research program to investigate the behavioral and emotional components of obesity and other weight-related problems. These studies will be conducted in close collaboration with the Obesity Clinical Program at Joslin.

Page last updated: October 28, 2016