Self-management of diabetes mellitus: a critical review.
Diabetes has no known cure and is a leading source of morbidity and mortality. Clinical management involves patients managing a complex and variable regimen. This article reviews the determinants of effective self-management and the methods of promoting better self-management. Trait variables (e.g., personality and demographics) have been presumed to affect self-management, but evidence suggests they have little impact. The important determinants of self-management are transient situational factors such as psychological stress and social pressure to eat. Interventions to promote better self-management have reported initial improvements in blood glucose control, but the long-term effects are unclear. We conclude that self-management has been inadequately assessed and that attempts to improve self-management have relied excessively on providing information. More research is needed to clarify determinants of self-management, and interventions to improve self-management will need to change these determinants.
Goodall
T A
TA
Department of Psychiatry, Royal Brisbane Hospital, University of Queensland, Herston, Australia.
Halford
W K
WK
D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D006801:Humans; D010349:Patient Compliance / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D012803:Sick Role
D001786:Blood Glucose