The importance of dietary changes and exercise for the proper management of type 2 diabetes is well documented. Doctors, educators and many people with the condition realize its benefits. The difficulty people with diabetes have making these lifestyle changes is just as well understood.

A study published in the January 1997 issue of Diabetes Care shows that a procedure called "motivational interviewing" may "significantly enhance adherence to program recommendations and glycemic control."

Motivational interviewing is a short, clinically tested intervention process that is designed to utilize individuals' personal motivation to change problematic behaviors. It has proven its effectiveness in several studies on people with drinking problems. In these studies, the interviews appeared to help subjects adhere to their standard alcoholism treatment programs.

The current study tested the effectiveness of combining these intervention programs on women with type 2 diabetes whose weight was 120 percent to 200 percent over the ideal. The control subjects, and those on motivational interview interventions, received identical recommendations for diet and exercise habits. The only difference was the presence or absence of motivational interviews.

In the interviews, direct confrontation was avoided. The women were not lectured on the best reasons to change. Instead, they were asked open-ended questions. Health care professionals used "reflective listening" to help the participants produce self-motivated expressions over the current status of their weight condition. In this way, participants came to recognize the advantages of change on their own accord rather than through instructions they had no participation in creating.

The motivational group demonstrated superior attendance to treatment meetings, turned in more exercise diaries, and exercised more regularly than the control group. The motivational group also had greater glucose control after the study.