Three main coping strategies seen in diabetic patients

People with diabetes may fall into one of three groups based on how they take care of themselves, new research shows.

Doctors treating diabetic patients should take note of which category best describes a person, and tailor their approach accordingly, Dr. Ivan J. Perry of University College Cork in Ireland and his colleagues conclude.

Perry and his team interviewed 17 people with type 1 or type 2 diabetes to learn how they saw and coped with their self-care responsibilities. The researchers identified a spectrum, ranging from "proactive managers" who not only followed recommendations but made adjustments on their own to their self-care as needed; to "passive followers" who stuck to a recommended routine, relied on others for guidance, and didn't adjust their care even if problems arose; to "nonconformists" who basically ignored self-care recommendations.

Most proactive managers used insulin or insulin plus oral medications and most were men. Among the passive followers, the majority had type 2 diabetes, most used diabetes pills but not insulin injections, and tended to rely on others and to resist change. Nonconformists are "often in denial about how diabetes will affect their future health," the researchers note.

Health care providers can help passive followers to become more proactive, Perry and his team say, while nonconformists, who may believe that diabetes self-care is simply too difficult for them, could learn from group sessions where they hear other people's "self-care success stories."

The researchers conclude: "Particular attention should be paid to the patient's self-care coping strategy, and self-care protocols should be tailored to complement the different patient types."

SOURCE: BMC Endocrine Disorders, online February 20, 2009.