Psychosocial and Biomedical Contributions to the Holistic Management of Diabetes Mellitus

Diabetes mellitus illustrates many of the dilemmas of modern medicine. In this chronic illness, meticulous blood glucose control can help avert long-term degenerative complications. There are widespread hopes that recent technological advances will put such control within reach of all patients. It is becoming increasingly clear, however, that blood glucose control reflects a variety of psychosocial factors as well as biomedical ones. Diabetes control is a joint venture between medical and behavioural scientists. Multifactorial approaches incorporate elements from different disciplines. Attempts to validate them have suffered from a number of problems. Lack of agreement about assessment procedures and measures of outcome, lack of precision about the population under examination and neglect of longitudinal research designs are the principal ones. As diabetes services begin to computerize patient records, this is the time to agree upon a minimum data set combining biomedical and psychosocial information.