Behavioural aspects of the management of diabetes mellitus: Education,self-care and metabolic control

A review is presented of factors relevant to the level of the knowledge, self-care and metabolic control of diabetic patients. Methods of assessing each of these are described, and ways of improving them reviewed. Recommendations are made for further work in this field.It is suggested that traditional education programmes have little clinical value beyond improving knowledge about diabetes. Among the recommendations made are approaches to the assessment and change of relevant health beliefs, and the use of behavioural methods of self-regulation, to improve the quality of self-care. The difficulties created by the variety of factors influencing metabolic control are discussed, with particular attention to the relevance of emotional stress.