Greater emphasis is needed on behavioural and psychosocial aspects in research and clinical practice
Wednesday 14 November marks World Diabetes Day, the birthday of Sir Frederick Banting, whose research led to the discovery of insulin in 1922. In the 90 years since, there have been other significant landmarks. The Diabetes Control and Complications Trial (DCCT)1 and United Kingdom Prospective Diabetes Study (UKPDS)2 showed that the devastating complications of diabetes can be prevented or delayed with intensive glycaemic management. However, this has proven virtually impossible to achieve and maintain in clinical practice. In Australia, the mean glycated haemoglobin (HbA1c) level of people with diabetes remains well above DCCT and UKPDS targets.3 This is unsurprising given the considerable challenges of managing diabetes on a daily basis: healthy eating, being physically active, taking medications as recommended, self-monitoring of blood glucose levels, all underpinned by healthy coping, problem solving, risk awareness and risk reduction. So, what makes the difference?
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