Self-regulation in the treatment of type II diabetes

The present study was designed to determine whether training patients with Type II diabetes to self-regulate their blood glucose by modifying their eating and exercise behaviors would improve weight loss or glycemic control. Twenty overweight patients with Type II diabetes were randomly assigned to behavioral weight control programs which included either self-monitoring of blood glucose only or extensive training in self-regulation of blood glucose. Subjects in the latter condition were taught to monitor blood glucose, to recognize discrepancies between actual and ideal blood glucose, to change eating and exercise behaviors to reduce these discrepancies, and to reinforce themselves for completing the steps in self-regulation. There was no evidence that this training in self-regulation improved short- or long-term outcome. Several explanations for these negative findings are considered, with the most likely explanation being that some patients were unable to achieve target blood glucose values despite making the prescribed changes in eating and exercise behaviors. In subsequent studies, it would be helpful to first identify a subset of Type II diabetic patients whose blood glucose levels are responsive to diet, exercise, and weight loss and then to train these patients to self-regulate blood glucose by modifying eating and exercise behaviors.