Maria da Graça Pereira1. 1. Associate External Editor of Revista Latino-Americana de Enfermagem, Associate Professor with Aggregation of Department of Applied Psychology, Escola de Psicologia, Universidade do Minho, Braga, Portugal. Email: gracep@psi.uminho.pt.
Diabetes, although a physiological disorder suffers the impact of negative psychological
stresses through the dysfunctional activation of the autonomic nervous and endocrine
systems. In fact, a variety of psychological variables have been found to be important in
the metabolic control and management of diabeticpatients, particularly regarding adherence
to self-care behaviors and medication. Lifestyle therapy is the cornerstone of diabetes
treatment and, therefore, any intervention that is able to achieve the control of
glycaemia, prevent micro and macro complications of diabetes, improve patient’s quality of
life and decrease diabetes risk factors is certainly welcome.Although acceptance of hypnosis and hypnotherapy by conventional medicine was officially
acknowledged in 1958, by the American Medical Association and the Canadian Medical
Association as a valid medical therapy, acceptance by health professionals has been slower.
However, a substantial body of research has demonstrated the efficacy of hypnosis as part
of the integrative treatment of many conditions that traditional medicine has found
difficult to treat
). In fact, hypnosis has shown not only to reduce anxiety in medical conditions
but also change physiological parameters
) and has been effective in the management of diabetes, including regulation of
blood sugar, increased compliance, weight loss in adults as well as adolescents. Recently
in an RCT, in type 1 diabetespatients, the hypnosis group decreased the standardized blood
glucose levels, while the control group increased
).One of the most problematic diabetic complications that is responsible for amputations is a
diabetic foot ulcer and hypnosis has shown positive results in increasing peripheral blood
circulation and decreasing diabetic foot problems. Also, mind-body interventions for
vascular complications of diabetes have been reported to be effective in relieving diabetic
angiopathy together with biofeedback. In general, the efficacy of hypnosis looks promising
in diabetic foot care.Hypnotic suggestions may indeed serve as a motivational coach and may be used effectively
to alter beliefs and behaviors and hence serve as an ancillary method in the management of
diabetes. The increased suggestibility shown during the hypnotic state would be helpful in
increasing compliance for exercise, diet, and other lifestyle changes required for diabetes
management, including stress reduction that is associated with the better metabolic
control. Hypnosis may also be a helpful tool to induce relaxation, decrease psychological
morbidity, often associated with diabetes, and accelerate wound healing, in case of
diabetic foot ulcers. Another advantage of hypnosis is the fact that the patients could be
taught self-hypnosis for home practice increasing patient’s sense of control over the
disease, enhancing treatment outcomes.In conclusion, there is evidence that hypnosis can help people with diabetes because has
shown to be a powerful method of helping people to change. This development might add
diabetes to the list for which hypnosis may be an effective therapeutic adjunct. Recently,
an approach called cognitive hypnotherapy
that integrates clinical hypnosis within a model a cognitive psychotherapy has been
proposed. This type of theoretical orientation is based on social constructivism in which
language and meaning constitute the core ingredients of psychotherapeutic interaction with
physically ill patients. Further research isneeded to assess the efficiency of this
refinement of cognitive behavioral therapy.In my viewpoint, the biggest challenge that hypnosis faces will probably be the dissipation
of misconceptions and the implementation of scientific perceptions of hypnosis. The
Zeitgeist may be ripe for an integrative medicine between the fields of
allopathic medicine and hypnotherapy i.e. ready for a true appreciation of the
interconnectedness of mind and body, in diabeticpatient’s healing. We only hope that,
hypnosis, together with other efficacious mind-body therapies may become an integral part
of the health practice in a renewed collaboration between mental and physical health
practitioners to optimally benefit patients.