Psychophysiological Aspects of the Management of Diabetes Mellitus

The management of diabetes mellitus presents many problems both for the people who suffer from diabetes and for medical practitioners prepared by their training to take responsibility and give directions for disease management. There is no known cure for diabetes mellitus, but the disease may be controlled by means of a continual monitoring and treatment regime; much of the success or failure in carrying out such a regime inevitably depends on the person with the diabetes. Medical practitioners make recommendations about insulin dosage and diet; but when diabetes control is inadequate, there appears to be a tendency for many practitioners to assume that their recommendations have not been followed. Insulin and diet are, however, only two of the many factors influencing blood glucose levels. Psychological factors have a powerful influence on blood glucose levels through the mechanisms of sympathetic nervous system activity. For those who recognize the important influence of psychological factors on blood glucose homeostasis, the management of diabetes mellitus presents a particularly interesting and challenging set of issues.