Diabetes is a chronic condition that reflects the fact that the body does not produce enough of the hormone insulin to break down the body's blood sugar and keep the blood-sugar count from being excessively high (Squires, 1997; Novitt-Moreno, 1996). But one of the most striking features about diabetes is the estimate that nearly one-half of those who have the disease are not aware of it (Type II, 1996; Squires, 1997). There are two types of diabetes, one congenital and the more common other type, known as diabetes mellitus or sugar diabetes, which mainly affects persons over 40 years of age. Symptoms include frequent urination, thirst, high blood pressure, and fatigue, and the condition is aggravated by overweight (Gomez & Gersh, 1968). Severe cases can cause heart disease, blindness, and arterial "furring," which cuts off blood supply to extremities (Susman & Helseth, 1997). This explains amputation of limbs in many diabetics (Dancer & Others, 1997; Needham & Others, 1993).
In part, psychological symptoms can be expected to proceed from physical ones and to connect in turn to an individual's social experience. For example, the need to urinate frequently could prove to be a social embarrassment, as could a pattern of unexplained and heavy perspiration that could not be attributed to, say, weather conditions. The stress that physical discomfort causes could have an adverse effect on interpersonal relationships, and of course there is bound to be stress owing to anxiety over the physical symptoms themselves. Add to this the fact that high blood sugar can aggravate thirst, hunger, and weight gain or loss that is otherwise unexplained, and the whole effect is one of potential psychological dysfunction. Dittbrenner cites the "shock" of having to come to terms with a negatively changed lifestyle on account of the chronic condition (1997). It also seems likely that the possibility for a diabetic to go into a coma would require him to alert...