Understanding the Diabetic Patient from a Psychological Dimension: Implications for the Patient and the Provider

The care of the diabetic patient represents a challenge to the health care professional. Considerable time and effort are invested in providing resources to the patient in the hope that there will be sufficient interest and awareness of the disease, resulting in increased motivation and compliance. It is ultimately expected that improved diabetes care will enhance the sense of well-being and reduce the risk of developing complications. Comprehensive health care today often involves a dietician and educator in addition to the physician. The multidisciplinary approach frequently provides the opportunity for individual and family counseling as well. Even when it does, the primary provider needs to be aware of the psychodynamics surrounding health care delivery. This aspect of patient care is so vital and yet is so frequently neglected.

Although many patients will do well in the course of their adaptation to and psychologic integration of diabetes, there are some individuals who will find this process difficult. It is with these individuals that this paper is principally concerned. Our goal as care providers is to be sensitive to and aware of those individuals who appear to resist the best efforts on their behalves. Rather than considering these individuals as delinquent or beyond hope, they too may be helped if we approach their underlying needs and fears with empathy and compassion. This approach will over time provide an opportunity to dispel myths or illusions that the patient or care provider may harbor and can engender a more productive and fruitful interaction. If we can accept ourselves realistically,