Diabetes: Behavioral Treatment

Angele McGrady & Sharon Williams Utz

Diabetes mellitus (DM) is a disorder of metabolism manifested by hyperglycemia. Type 1 and Type 2 are the primary types of diabetes. Although different in etiology, both types exhibit a high degree of comorbidity with other disorders, primarily hypertension and dyslipidemia. Long-term complications include microvascular, macrovascular, and neurological damage. The etiology of Type 2 DM rests squarely on behavior, particularly overeating, lack of exercise, and poor food choices. Psychological stress exacerbates hyperglycemia in most persons with DM by mobilizing glycogen resources in the liver and increasing glucose in the bloodstream. Cell membranes resistant to insulin prevent entry of glucose into the cells. Management of DM comprises hypoglycemic medication (insulin and/or oral agents), which must be taken daily, regular monitoring of blood glucose, controlled diet, exercise, and stress management. The first steps rely on structured education about selfcare; self-care behaviors remain the cornerstone of therapy. Changing dietary choices, increasing exercise, and ...

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