Management of a Patient With Insulin-Dependent Diabetes Mellitus Learning Biofeedback-Assisted Relaxation

Abstract

Psychological stress can have profound disruptive effects upon glycemic control in individuals with diabetes. Presented here is a case study in which biofeedback- assisted relaxation techniques were used to help a young woman with a 10-year history of insulin- dependent diabetes mellitus to more effectively manage stress, thereby improving glycemic control. Hypoglycemia is a frequently encountered problem with this technique, so the patient was taught to identify causes of hypoglycemic episodes and to take action to prevent their occur rence. The team approach of a diabetes nurse educator working in conjunction with a biofeedback therapist was vital to the success of this program.

Get full access to this article

View all access options for this article.

References

Schwartz MS , et al. Biofeedback: a practitioners guide. New York : Guilford Press, 1987.

Lammers CA , Naliboff BD , Straatmeyer AJ The effects of progressive relaxation on stress and diabetic control . Behav Res Ther 1984;22:641-50.

Landis B. , Jovanovic L. , Landis E. , et al. Effect of stress reduction on daily glucose range in previously stabilized insulin-dependent diabetic patients. Diabetes Care 1985;8:624-26.

Feinglos MN , Hastedt P. , Surwit RS Effects of relaxation therapy on patients with type I diabetes mellitus . Diabetes Care 1987;10:72-75.

Gaarder KR , Montgomery PS Clinical biofeedback: a procedural manual. Baltimore : Williams & Wilkins, 1977 .

Cox DJ , Gonder-Frederick LA The role of stress in diabetes mellitus. In: Behavioral medicine handbook of diabetes mellitus. Champaign, Illinois : Research Press, 1989:1-27.

Fowler JE , Budzynski TH , Vandenbergh RL The effects of an EMG biofeedback relaxation program on the control of diabetes . Biofeedback and Self-Regulation 1976;1:105-12.

Seeburg KN , DeBoer KF Effects of EMG biofeedback in diabetes. Biofeedback and Self-Regulation 1980;5:298-93.

Budzynski TH , Stroyva JM , Adler CS , Mullaney DA EMG biofeedback and tension headache: a controlled outcome study. Psychosom Med 1973;35:484-96.

10.

Green EE , Green AM , Norris PA Preliminary report on a new non-drug method on the control of hypertension . J SC Med Assoc 1979;75:575-82.

11.

Jacobsen E. Progressive relaxation. 2nd ed. Chicago: University of Chicago Press, 1980.

12.

Rosenbaum L. , Tannenberg RJ , Eastman RC Insulin/dextrose infusion system confirms biofeedback effect: IDDM case study. Diabetes 1986;35(suppl):112A.