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TABLE 2.

Situations That Warrant Referral of a Person With Diabetes to a Mental Health Provider for Evaluation and Treatment

• If self-care remains impaired in a person with diabetes distress after tailored diabetes education 
• If a person has a positive screen on a validated screening tool for depressive symptoms 
• In the presence of symptoms or suspicions of disordered eating behavior, an eating disorder, or disrupted patterns of eating 
• If intentional omission of insulin or oral medication to cause weight loss is identified 
• If a person has a positive screen for anxiety or fear of hypoglycemia 
• If a serious mental illness is suspected 
• In youth and families with behavioral self-care difficulties, repeated hospitalizations for diabetic ketoacidosis, or significant distress 
• If a person screens positive for cognitive impairment 
• Declining or impaired ability to perform diabetes self-care behaviors 
• Before undergoing bariatric or metabolic surgery and after surgery if assessment reveals an ongoing need for adjustment support 
• If self-care remains impaired in a person with diabetes distress after tailored diabetes education 
• If a person has a positive screen on a validated screening tool for depressive symptoms 
• In the presence of symptoms or suspicions of disordered eating behavior, an eating disorder, or disrupted patterns of eating 
• If intentional omission of insulin or oral medication to cause weight loss is identified 
• If a person has a positive screen for anxiety or fear of hypoglycemia 
• If a serious mental illness is suspected 
• In youth and families with behavioral self-care difficulties, repeated hospitalizations for diabetic ketoacidosis, or significant distress 
• If a person screens positive for cognitive impairment 
• Declining or impaired ability to perform diabetes self-care behaviors 
• Before undergoing bariatric or metabolic surgery and after surgery if assessment reveals an ongoing need for adjustment support 
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