FIT: A paradigm shift that recognises the importance of dietary freedom and quality of life in diabetes management.

摘要

I was asked by the editorial board of Health Psychology Update to contribute to the centenary issue of Update by writing about a publication that inspired, impressed, or simply interested me. The book I have selected has done all three. It is a book by Kinga Howorka entitled ‘Functional Insulin Treatment’ and was published in its second English edition in 1996 by Springer-Verlag (Howorka, 1996). The fifth German edition and third English edition are soon to be published as is a new edition of a version written for patients. Kinga Howorka and I share the view that diabetes physicians make unrealistic demands on their patients when they expect them to inject specified amounts of insulin at set times of day and then to eat specified amounts of carbohydrate at regular intervals in order to avoid hypoglycaemic episodes. In our work at Royal Holloway to develop an individualised measure of impact of diabetes on quality of life, we have found that dietary restrictions imposed by most diabetes treatments do the most damage to quality of life (Bradley et al., 1999; Speight & Bradley, 2000).