Diabetes is a largely self-managed disease. Consequently, if the patient is unwilling or unable to self-manage his or her diabetes on a day-to-day basis, outcomes will be poor, regardless of how advanced the treatment technology is. Cognitive, emotional, behavioural and social factors have a vital role in diabetes management. More so, as co-morbid depression and other psychological problems are prevalent and negatively impact on well-being and metabolic outcomes. There is more to diabetes than glucose control; it requires a biopsychosocial approach. Motivational counselling and behaviour change programmes in type 2 diabetes have shown to be effective in improving adherence and warrant further dissemination in primary and secondary care. In type 1 diabetes, adolescents are at increased risk of coping difficulties and poor diabetes outcomes, and warrant special attention. For all age groups, monitoring of patients' emotional well-being as an integral part of routine diabetes care is recommended. Discussion of quality-of-life issues in the context of clinical diabetes care in itself promotes adherence and patient satisfaction, and has proven to increase recognition of signs of emotional problems and 'diabetes burnout'. Integrating psychology in diabetes management can help to effectively tailor care to the patient's individual needs and improve outcomes.
- behaviour change
- psychosocial care