Addressing Mental Health in Diabetes Care: Outcomes of DSME Intervention in Nigeria

Background: Type 2 diabetes mellitus (T2DM) has multisystemic effects on health and healthcare services. However, its impact on mental health has not received much attention particularly in low resource settings like Nigeria. This study investigates the effects of a structured Diabetes Self-Management Education (DSME) program on mental health outcomes among T2DM patients in Nigeria. Methods: A quasi-experimental, pre-test/post-test design was employed at Olabisi Onabanjo University Teaching Hospital, involving 145 T2DM patients. Mental health was assessed using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Diabetes Distress Scale (DDS). Participants underwent a 12-week DSME program covering diabetes education, nutrition, physical activity, glucose monitoring, medication management, and stress coping skills. Results: Post-intervention analysis revealed a significant reduction in mental health and anxiety scores. Pre-test mean scores of 33.68 (SD = 5.773) decreased to 27.83 (SD = 6.306) post-intervention (mean difference = 5.85, p < 0.001). The DSME program demonstrated a substantial positive impact on psychological well-being, with an effect size of 1.01. Conclusion: The DSME program significantly improved mental health outcomes among T2DM patients in Nigeria. These findings underscore the importance of integrating mental health support into diabetes management programs, particularly in settings with limited mental health resources. Future research should focus on the long-term sustainability of these improvements and cultural adaptation of DSME programs.