Diabetes debut can generate anxiety and other symptoms of depression on several occasions, especially for the concern of having a chronic disease.

The patient has a hard time assuming the situation.

The new changes of daily habits must be assimilated.In some cases they give rise to sadness, nerves or anxiety.The way of raising awareness of this diabetic patient is through an adaptation process.Do not think excessively about the complications that this disease can bring.

It is convenient to focus on those habits that it can modify and that will lead them to lead a healthier life;take care but not worry.

Given the diagnosis of diabetes, several attitudes can be adopted.Flee or deny.When they have just diagnosed diabetes it is easy and normal to want to escape, to disappear, have feelings of disability and helplessness, of not wanting to face;As the anguish appears, it is avoided thinking about it and flees from the problem.Similarly, the patient can try to underestimate him, do nothing and continue with your life denying importance.This may work for a while, but then it ends up taking its toll.Diabetes is silent but is doing its effect if appropriate measures are not taken.And even if the patient tries to think about it, the anxiety of suffering from it is there.

The second attitude is victimhood.It is another habitual reaction after the diabetes debut.Find a culprit among others.It is a harmful attitude in the medium term since it ends up undermining the mood and usually exaggerates reality towards the negative.It is also true that stopping feeling victim is difficult because victimism gives an identity and is comfortable, since you just have to expect others to take responsibility for your needs.But persistence in this attitude can lead to sadness and rage.In general, it enters a vicious circle in which both the desire to flee and victimism end up leading to passivity, promoting apathy and impotence.In this vicious circle diabetes or any other negative fact end up controlling life.

And the third way of receiving the diagnosis of diabetes is with active coping.When the human being manages to face what torments him, he finds a satisfaction with himself so full that he can feel good even in the most difficult situations.An attitude of rejection and fighting diabetes is worth it because it will not leave, it will remain there and sooner or later it will have to be faced.

Adopting a positive attitude towards the facts can help, since it is well known that difficult situations are those that usually bring to light.DM2 is a chronic process that affects a large number of people, so it constitutes a problem at the individual and public health level of great proportions.

Information-knowledge

The diabetic patient requires extra information when understanding the disease due to the follow -up that this patient has to have so that the evolution of the disease is satisfactory.Sociocultural factors can favor or limit compliance.The objective is to identify the self -care that diabetics need, as well as the sociocultural factors that favor or limit compliance.In this category are economic, disease and occupation.

Some patients explain that they have sought support to cope with mood alterations.In any case, it seems that there is little psychological support established in an organized and routine way in health services specifically for diabetic people.The general recommendation is that diabetes is part of your life and you have to take it as well as possible and rely on the people of the environment.

So,The first step to achieve adherence to treatment is to provide information and adopt preventive behaviors.Patients should be given responsibilities in their treatments, preventing relapses, supporting families in training and information.

In reference to patient care, it is necessary to know how to put the insulin, as well as all prescribed drugs and the care of the diabetic, such as the care of the feet, retinopathies, and the diets to be carried out by the patient.The participation of group training programs for diabetes show better control of the disease and knowledge about it.

self -care

The autonomous patient includes the meaning of type 2 diabetes, their chronicity characteristics, the objectives to be achieved, the therapeutic approach strategies based on hygienic-dietary habits and drugs, with the various existing options.The attitude of the patient with DM2 oriented to control over their health and their disease, being able to acquire all the necessary skills and handle that diabetes and cardiovascular risk factors, ultimately, the self -care of their clinical picture is ideal.

In this sense, education as a therapeutic strategy is the fundamental basis for the management of DM2, so that all maneuvers aimed at changing behavior and problem solving by the patient are fundamental.

The real challenge when a person is diagnosed with a disease such as diabetes is "that" learning to live and care for a circumstance that has not been chosen.Incorporate care, trying to hinder as little as possible in your life.

clarify doubts

The knowledge of the drug professional, transmit security and confidence to the patient with respect to it, of its side effects;Clarify doubts about myths about them .. Easy handling posologies, avoid multiple doses, or try to be comfortable to administer, with recognizable and easy to remember commercial names.Always try to simplify treatments, for example with polyper treatments, especially in the elderly patient.

In that context, we must improve medical-patient communication, with a language that adapts to the diabetic, taking into account impatience, frustration for not achieving objectives, the lack of understanding, the difficulty of explaining the symptoms, theFear of expressing themselves, the perception of little time in the consultation and the difficulty in prioritizing symptoms.The ADA-EASD consensus declaration establishes the elements to consider and that can guide the professional in the choice of treatment focused on a specific patient.Factors and clinical situations to consider in the individualized treatment of DM2 are the motivation, attitude of the patient and effort expectations (very motivated, adhesion and autonomy. Little motivated, with little adherence to treatment and poor autonomy);the risk of hypoglycemia, potential risk associated with hypoglycemia and other adverse effects;disease duration;life expectancy, important comorbidities, established vascular complications, cultural and socio-economic resources, adhesion, self-care capacity, external support and objectives of HBA1C to be achieved, more demanding 6-6.5 percent or less demanding 7.5-8 percent.

For the elaboration of this article, the collaboration of doctors David Molina Fernández, Cristóbal Muñoz Zamora, Mª Ángeles Miranda Sánchez, Indalecio Caballero Pérez, Alfonso Jiménez Ceacero, Manuel Bravo, Del Jaén;Carmen Suárez Ceballos, Catalina Cárdenes, Juan Ramón Peraita, Juan Ramírez and Julián Andrés Tamayo Serrato, San Roque Forum;Primary care doctorsAntonio García Fernández, Alfonso Hidalgo Pineda, Carlos Javier Berral de la Rosa, Amador Velarde Escoriza, Rafael Ángel Cejas López, Juan Merino Polo, José María Castro Ramírez, César Sánchez Nieto, Manuel Moreno Rodríguez, the internist Francisco José Fuentes Jiménez, Manuel ÁngelJiménez Torres, María Asunción Gil López, José Manuel García Gersol, Fernando Báez Cruz and Manuel Moreno Rodríguez, Córdoba, and Alejandra Domínguez, María del Carmen Mesa, Grigliola Salazar, Celia López, José Luis Pérez, José Gerardo Pérez and Guetel Duarte.