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A questionnaire study of 197 insulin-dependent diabetics which was supplemented by individual interviews with fourteen of the respondents suggests that few diabetics maintain tight control. Most maintain the level of control at which they are most physically or psychologically comfortable. However, tight control is feasible for the average diabetic. The main factors which impede tight control are difficulty coping with stresses of daily living, eating to satisfy emotional needs, discomfort at euglycemic levels, and fear of hypoglycemia. Re-regulation must therefore employ temporary reduction of life stress, some impediment to snacking, support through the discomfort of altering blood sugar level, and careful monitoring to avoid severe hypoglycemia. A specific type of hospital experience and/or involvement in an outpatient educational and treatment milieu are possible avenues to provide these necessary factors.
Weiner et al. (Sat,) studied this question.