Stopping insulin injections following genetic testing in diabetes: impact on identity
Article first published online: 30 APR 2010
© 2010 The Author. Journal compilation © 2010 Diabetes UK
Volume 27, Issue 7, pages 838–843, July 2010
How to Cite
Shepherd, M. (2010), Stopping insulin injections following genetic testing in diabetes: impact on identity. Diabetic Medicine, 27: 838–843. doi: 10.1111/j.1464-5491.2010.03022.x
- Issue published online: 30 JUN 2010
- Article first published online: 30 APR 2010
- Accepted 17 April 2010
- biographical disruption;
- genetic testing;
- monogenic diabetes
Diabet. Med. 27, 838–843 (2010)
Background Identification of genes causing monogenic diabetes has led to treatment change, from insulin to sulphonylureas for many previously considered insulin dependent. Changing treatment has led to improved glycaemic control and quality of life; however, the impact of a genetic diagnosis and consequent treatment change on identity has not been explored.
Methods This paper examines the experiences of patients and their families using Bury’s theory of biographical disruption in chronic illness to offer insight and comparison with the disruption caused by treatment change following genetic testing. This qualitative study is a longitudinal follow-up using in-depth interviews over time. Thirty-one individuals were interviewed following genetic testing and again 12 months later.
Results Key themes identified were: (i) embodied practices of diabetes; (ii) perceived identity on insulin; (iii) ‘holding on’ to insulin treatment; (iv) challenges and benefits of treatment change; (v) identity reconstruction. Participants were categorized into ‘Transferers’ who successfully transferred to sulphonylureas, ‘Attempters’ who attempted transfer but recommenced insulin and ‘Decliners’ who declined treatment change.
Conclusions Injecting insulin was integral to participant’s lives and fundamental to their identity. Embodied practices of diabetes were deeply embedded in self identity; the possibility of stopping insulin injections was a major challenge contradicting previous beliefs and led to identity reconstruction.