The assessment of a patient with diabetes is a good example of the need for a system approach. A well adjusted patient with a supportive family and few environmental stresses is likely to find it relatively easy to attain goals of therapy and maintain control. Patients without these advantages may present several kinds of management problems. If there are family problems, the patients may be too preoccupied by them to attend to his or her own needs, lack of family support may make it difficult to adhere to a diet. The diabetes itself may be used for secondary gain by the patient, thus giving him or her and interest in its continuation.
Emotional stresses can have a direct effect on carbohydrate and fat metabolism.