Self-management skills are ingrained in the control of diabetes. Ed Fisher and coworkers reviewed the literature pertinent to healthy coping in diabetes management and to identify effective or promising interventions and areas needing further investigation. A Pub Med search identified 186 articles in English published between January 1, 1990, and July 31, 2006, that addressed diabetes and emotion, quality of life, depression, adjustment, anxiety, coping, family therapy, behavior therapy, psychotherapy, problem solving, couples therapy, or marital therapy. It was found that connections among psychological variables, behavioral factors, coping, metabolic control, and quality of life are appreciable and multidirectional. Interventions used in well-controlled studies indicate benefits for quality of life and/or metabolic control include general self-management, coping/problem-solving interventions, stress management, support groups, cognitive-behavioral therapy, behavioral family systems therapy, cognitive-analytic therapy, multisystem therapy, medications for depression, and the Pathways intervention integrating case management, support of medication, and problem-solving counseling.

VALUE OF STUDY TO READER: Fisher and colleagues concluded that psychological, emotional, related behavioral factors, and quality of life are important in diabetes management, are worthy of attention in their own right, and influence metabolic control. Components regarding these topics will undoubtedly be incorporated into future self-management studies for diabetes and other chronic disorders.

EB Fisher et al. Healthy coping, negative emotions, and diabetes management: a systematic review and appraisal. Diabetes Education, 2007;33:1080-1103.