A biopsychosocial treatment approach to the management of diabetes mellitus

Gen Hosp Psychiatry. 1991 Jan;13(1):19-26. doi: 10.1016/0163-8343(91)90005-h.


The relationship among recent life stress, social support, a patient's locus of control, and the control of blood glucose is evaluated in persons with diabetes mellitus, using objective measures of these psychosocial variables. Short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] control measures are taken at two points in time in order to evaluate the effects of the psychosocial variables on change in diabetes control. For life events, a significant positive association was found between the number of recent life events and blood glucose control. Decrease in social support predicted a worsening of longer-term (Hgb A-1C) control over time. An external locus of control within the patient was associated both with poor short-term control at time one and prediction of poorer long-term control over time. The implications of these findings are discussed in support of a biopsychosocial approach to the management of diabetes mellitus.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Blood Glucose / analysis*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / psychology
  • Diabetes Mellitus / therapy*
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Internal-External Control*
  • Life Change Events*
  • Outcome and Process Assessment, Health Care
  • Social Support*
  • Stress, Psychological / psychology


  • Blood Glucose
  • Glycated Hemoglobin A