Precision Diabetes Medicine Needs Precision Mental Health Care
François Pouwer, Katharine Barnard-Kelly, Bryan Richard Cleal, Debbie Cooke, Mary de Groot, Sonya Deschênes, Dominic Ehrmann, Anthony Fernandez, Lisbeth Frostholm, David Hopkins, Norbert Hermanns, Richard I.G. Holt, Marjolein Memelink Iversen, Thomas Kubiak, Christina Maar Andersen, Briana Mezuk, Giesje Nefs, Susanne S. Pedersen, Miranda Schram, Frank Snoek, Uffe Søholm, Timothy C. Skinner, Søren Skovlund, Marietta Stadler, Ragnhild B. Strandberg, Sarah Bro Trasmundi, Michael Vallis, Kirsty Winkley, Per Winterdijk, Maartje de Wit, Natalie Zaremba, Jane Speight, on behalf of the international PsychoSocial Aspects of Diabetes (PSAD) Study Group.
The missing piece: The clinical translation of precision diabetes medicine requires precision mental health care: A call to action from the international PsychoSocial Aspects of Diabetes (PSAD) Study Group. Diabet Med. 2025 May;42(5):e15514.
Precision diabetes medicine aims to tailor prevention, diagnosis and treatment to individual biological and lifestyle characteristics. The first international consensus on precision diabetes medicine recognised that psychosocial and mental health factors are important components of this approach. In contrast, the second consensus report, published in 2023, did not include psychosocial aspects, even though evidence shows that mental health strongly influences diabetes risk, self-management and clinical outcomes.
Research has demonstrated that depression, anxiety, diabetes distress, disordered eating and sleep problems can negatively impact glycaemic control and quality of life. International guidelines already recommend routine psychosocial assessment and access to psychological support in diabetes care. The authors argue that excluding these aspects from the precision medicine agenda leaves the concept incomplete.
This paper is a commentary, not an empirical study. The authors highlight the omission of psychosocial content in the recent consensus on precision diabetes medicine and outline why mental health, behavioural factors and social context should be considered essential components of precision care. They emphasise that precision diabetes medicine must account for psychological diversity as well as biological diversity.
Key findings:
- The second precision diabetes medicine consensus report largely omitted psychosocial and mental health aspects despite their recognised relevance.
- Mental health problems and psychosocial factors influence both the risk of diabetes and clinical outcomes across the life course.
- Existing guidelines already recommend routine psychosocial screening and access to mental health support in diabetes care.
- Effective psychological interventions exist but were not considered in the latest precision medicine recommendations.
- Precision diabetes medicine that ignores psychosocial factors risks being incomplete and inequitable.
The commentary argues that precision diabetes medicine should integrate systematic assessment and tailored intervention for psychosocial issues, alongside biomedical precision. This includes recognising psychological profiles, embedding mental health care within diabetes services, and ensuring future research and consensus work explicitly consider psychosocial outcomes. The authors position this approach as necessary for precision medicine to have meaningful clinical impact.
Concluding the authors state
"Mental health is as important a goal of precision diabetes medicine as physical health, and precision diabetes medicine must also entail precision mental health care." -
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