DIABETES CARE IS SELF-CARE
Self-care is a critical issue in diabetes because more than 99% of diabetes care is self-care. The vast majority of diabetes care takes place not more than 2 or 3 times a year in the clinics, but literally countless times each day in the places where people with diabetes live, work, eat and play.

Levels of self-care and glycaemic control among people with diabetes are alarming. The average HbA1c of a person with type 2 diabetes is 9.5%, representing an average blood glucose level of about 250 mg=dl or about 14 mmol=l.

It is apparent that one essential goal of diabetes care is to improve diabetes-related coping skills among people with diabetes and, as a consequence, to improve self-care behaviour, metabolic outcomes and qual- ity of life as well. Quality of life is affected by improved coping skills, both directly, through reduced emotional distress, and indirectly, through the effects of coping skills on self-care, glycaemic control and long-term health outcomes.


Relaxation can improve tolerance

A variety of studies over the past two decades support the notion that improving stress management or coping skills can improve self-care, meta- bolic outcomes and quality of life.


Therapy groups

In addition, a wide range of interventions including therapy groups, self- help groups, support groups and diabetes camps have been employed to promote more effective coping with the day-to-day hassles of diabetes. Most of this reseach, which was designed to improve the ability of children and adolescents to use social skills and assertive behaviour for coping effectively with diabetes-related interpersonal situations, involved small numbers of subjects and did not include either a control group or follow-up measures.