Psychological issues in the diabetes clinic

Psychological difficulties and their effect on diabetes management and diabetes control continue to be debated, whilst the need for psychological treatment is ignored. St Thomas' and Guy's Hospitals offer structured psychological support for their poorly controlled patients using Cognitive Analytic Therapy (CAT). Brief details of CAT are given and the change which occurs in the therapy is outlined in a letter written by a patient at the end of treatment. If we are to maximise diabetes services and minimise disability, psychological treatment needs to be made available to our patients.