LOCUS OF CONTROL AND METABOLIC CONTROL

Previous studies designed to establish in diabetic patients the relationship between metabolic control and locus of control are controversial. The aim of the present study was to find answers to the following questions: is there a link between an internal locus of control and improved metabolic control ? Is this true for type I and type II diabetic subjects ? Is this improved metabolic control linked directly, or even indirectly, with the locus of control by types of behaviour, such as for example a greater desire for information concerning the disease (knowledge) and closer adherence to doctors' recommendations (compliance) ? Sixty-one patients (36 type I and 25 type II) on insulin therapy were compared according to the type of their locus of control using two different questionnaires (Rotter and Wallston). The extent of their knowledge about diabetes was also assessed; self-monitoring of blood glucose (SMBG) was considered to be a measure of compliance; while the HbA(1) level was considered to be an indicator of metabolic control. The study compared the influence of the type of locus of control on the various parameters. The results indicate that, irrespective of the questionnaire, type I ''internals'' exhibited better metabolic control (p < 0.05) than type I ''externals'', even with a lower level of knowledge of diabetes (p < 0.01) and less frequent SMBG (p < 0.05). However, the benefits of internality as regards metabolic control were not as great when this internality was extreme. In conclusion, the data showed different patterns of interactions between locus of control and metabolic control in type I and type II patients, suggesting that internal type I subjects, apart from the extreme cases, could have a kind of ''internal clock'', that is, a better awareness, understanding and metabolic control of their illness despite a lower knowledge.