The role of the optimal healing environment in the care of patients with diabetes mellitus type II.

An optimal healing environment (OHE) can include both general and specific physical, medical, behavioral, psychological, social and spiritual components. Type 2 diabetes mellitus, primarily a disease of lifestyle, provides an excellent opportunity to investigate the potential impact of this broader model of care on a chronic illness. This paper proposes a strategy for studying the application of the OHE model to the care of patients with type 2 diabetes. It provides a brief review of the current literature on prevention of type 2 diabetes in patients at high risk, and then discusses the evidence for and against a variety of interventions for established diabetes mellitus including nutritional, herbal, mind-body and exercise strategies. The essential elements of a protocol for an integrative medicine or OHE approach to diabetes are then outlined, followed by a discussion of the research issues that would emerge from an effort to test the effectiveness of such an approach.