This article examines psychological issues and their treatment among people
with diabetes. The paper contains two main sections, one dealing with diag
nosable clinical disorders, and the other with more mundane but nevertheles
s important subclinical problems in living with diabetes. We review the pub
lished literature on prevalence, manifestation, consequences, and treatment
of psychological disorders in persons with diabetes, primarily depression,
anxiety, and eating disorders. in describing everyday problems in living w
ith diabetes we expand our sources beyond the published literature to inclu
de our own clinical and consulting experiences as well as our unpublished q
ualitative research. These problems include dietary restrictions, self-moni
toring of blood glucose, taking insulin injections, and lack of support fro
m family and health care professionals. We describe methods for dealing wit
h such problems and discuss the tension between focusing on emotional distr
ess versus practical issues of disease management. Finally, we briefly pres
ent some potentially positive consequences of living with diabetes so that
readers can be aware of the inspirational aspects of personal experience wi
th this disease. (C) 2001 John Wiley & Sons, Inc.