It is well known that diabetes can cause sexual problems in both men and women; however, these problems are rarely discussed by the physician. This can lead to psychological problems and further worsen the already curtailed sexual performance. Depression is common among diabetics but it is not always recognized as an illness that needs treating. Instead it is seen as an understandable reaction to a chronic disorder. It is known that the aetiology of diabetic sexual dysfunction is multifactorial and commonly includes both organic and psychogenic factors. Psychogenic factors are implicated more than was once thought and exploration of these factors can teach patients to deal with their fears and achieve good disease acceptance. Many diabetics expect their physician to provide counselling and only a minority need more skilled intervention from expert therapists. Counsellors can re-educate patients and modify behaviour such that the patient can enjoy sexual function within whatever limits are imposed by irrversible factors. There is, however, little research on the matter and further research needs to be done in the evaluation of psychological therapies.