Psychological aspects of diabetes management

Diabetes is recognized as one of the most emotionally and behaviourally demanding chronic illnesses, yet most patients seem to adapt to and cope reasonably well with the disease and report a satisfactory quality of life. Psychosocial adaptation is an important outcome of diabetes care, from the perspective of both quality of life and the effectiveness of treatment. Patients in poor psychological health lack the motivation and emotional strength to self-manage their diabetes in the long term.

Adaptation starts with the diagnosis, to which individuals respond differently. The diagnosis of diabetes may come as a shock, and can induce emotional distress in patients and their family. Research indicates that emotional equilibrium is restored in most patients within several months to 1 year after diagnosis, and the diabetes is more or less integrated into their daily lives. Some patients initially react with indifference, or even relief, on discovering that it was ‘only’ diabetes that caused their physical complaints, rather than cancer or another ‘lethal’ condition. Screening studies have shown that older patients with type 2 diabetes do not always perceive their condition as a burdensome disease, particularly when it is diagnosed at an early stage when blood glucose-lowering medication is not yet required. The increasing number of overweight children and young adults developing type 2 diabetes is a major physical and psychosocial concern. Little is known about how these young people cope with the disease and the prospect of developing debilitating complications in the future.