A very aggressive behavior or a Type A personality will naturally cause a surge of anti-insulin hormones and cause faster progression from prediabetes to diabetes.

What are the major barriers to addressing psychological problems in diabetic patients?

Many of the people with diabetes have occult depression which manifests as poor compliance to diet, medication and SMBG. However, most diabetes clinics do not have an in-house psychologist to assess and counsel such patients.

What are the therapeutic interventions to reduce the burden of obesity?

There are very few therapeutic options to treat obesity. Using higher doses of metformin, avoiding hypoglycemia and use of agents like SGLT2 inhibitors can help to reduce the weight gain in patients with diabetes.