This chapter first describes the characteristics of diabetes mellitus and discusses the traditional management of the disease. It then explores the impact of psychological variables and lifestyle factors on the control of diabetes. The chapter mainly addresses general clinical procedures for treatment with biofeedback and relaxation combined with traditional medical therapy. We discuss recommendations for types of and number of treatment sessions, home practice, and communication with a patient's physician. Next, we summarize important considerations in using biofeedback for persons with diabetes, and we discuss possible contraindications to treatment. A brief summary of research studies is given at the end of the chapter. (As in other chapters, italics on first use of a term indicate that the term is included in the glossary at the end of the chapter.)
More empirical research is necessary to establish and advance a psychophysiological approach to diabetes. However, the overall results are encouraging, and practitioners using relaxation and biofeedback can welcome referrals of patients with diabetes. Treatment of patients with diabetes involves particular risks and requires specialized knowledge. Thus practitioners using relaxation and biofeedback must have this knowledge and work as part of a treatment team.
Diabetes mellitus is a chronic disorder of metabolism affecting about 16 million people, or 6–7% of the United States population (Diabetes Research Working Group, 1999). High blood glucose (sugar), known as hyperglycemia, characterizes diabetes. Hyperglycemia results from either relative or absolute insulin deficiency. Glucose is one of the products that results from the breakdown (metabolism) of ingested food, principally carbohydrates. Glucose is the body's main fuel source and typically the brain's only energy source. Blood glucose levels are recorded as milligrams per deciliter or as millimoles per liter (abbreviated mg/dl and mmol/l, respectively, with specific numbers).
The glucose level in the blood normally rises after a meal. This increase prompts the pancreas, an organ that lies behind the stomach, to secrete the regulatory hormone called