Psychological issues and treatments for people with diabetes

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our sources beyond the published literature to inclu de our own clinical and consulting experiences as well as our unpublished q ualitative research.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.