The psychosocial aspects of diabetes (PSAD) caxre are increasingly occupying center
stage in diabetology, and rightfully so.[1] An increase in the prevalence of diabetes across age groups, gender, and nation
societies enhanced understanding of the multifactorial biological basis of the disease,
and an acute realization of the limitations of purely biology or pharmacology-based
therapy have led to this trend. Policy makers now appreciate the public health and
economic impact of diabetes. Researchers have unraveled patho-physiological defects,
which provide a bridge between bio- and psycho-social aspects of diabetes, making
it a perfect example for the bio-psycho-social model of disease. While pharmacologists
have created novel therapeutic interventions based upon this research, clinicians
appreciate (painfully) the truth that purely pharmacological approaches do not succeed
in controlling diabetes. Our patients concur.
Psycho-social factors play an important role in the development, natural history,
and management of diabetes. Detailed guidelines are available from various professional
bodies, which encourage the assessment and management of general, psychological, psychiatric,
and social factors, which impact glycemic control.[2] While some of these documents are specific for children, others have universal coverage.
Some documents provide generic overview of the subject, while others address cross-cultural
issues and encourage patient-specific, community-specific intervention. In parallel
with this development, qualitative, and mixed methods research are gradually being
accepted as valid health research methodologies.[3]
[4]
However, as a separate entity or sub-specialty, the science of PSAD faces certain
hurdles. This subject has not grown as rapidly as obstetric diabetes. It has not received
the same amount of attention as cardiovascular diabetology, eye disease, or renal
disease has. Part of the reason may lie in its unwieldy nomenclature; PSAD is quite
a mouthful. Other eponyms such as psycho-socio-diabetology or social and diabetology
hardly fare better. The main reason, paradoxically, is the universal importance of
PSAD; it affects every stakeholder in diabetes. Hence, no one takes ownership of this
specialty. This is in contrast to the other subspecialties mentioned above, which
are limited to particular age groups or to specific organ systems. Another factor,
which has stymied the growth of PSAD, is its multidisciplinary nature, and the challenge
of getting specialists from diverse field together to make a meaningful impact.
These challenges, however, need not be viewed as obstacles. Rather, they are stepping
stones to achieving greater growth, using cross-discipline fertilization, while celebrating
the diversity of diabetes. Better ideas and practices will be born, however, only
if existing knowledge is disseminated. Best practice sharing, novel research, viewpoints,
and commentaries, all have their role to play in this regards. In PSAD, as in other
field of medicine, both clinical practice and research should complement each other.
Mutual learning and improvement must be ensured by ensuring efficient sharing of knowledge.
In today's technology-driven world, the open access model of publishing, using both
online and print media, offers a convenient means of doing so. Our journal fits all
these criteria.
As we work towards containing diabetes, PSAD need to be given adequate attention.
Concerted, sustained, and efficient team work, involving all health care professionals
and other stakeholders, is necessary if we are to take to make a meaningful impact.[5] Every possible soldier must be mobilized to mitigate the effects of diabetes pandemic.
Every diabetes care professional must be made aware of PSAD, sensitized to its importance,
and empowered to optimize PSAD.
To contribute towards this goal, we present the inaugural issue of Journal of Social
Health in Diabetes (JoSH-Diabetes) with confidence and pride. In many South Asian
languages, the word JOSH means enthusiasm. A multidisciplinary, multi-continental
compendium of articles, written in multiple styles, it brings the field of psycho-social
aspects of diabetes to life. Each author exudes JoSH, or enthusiasm, through her or
his words, and conveys the social health issues related to diabetes.
Through JoSH-Diabetes, we hope to achieve a significant impact in the psycho-social
health of people with diabetes. We hope our patients will concur.
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