Stopping insulin injections following genetic testing in diabetes: impact on identity.

Diabetic Medicine : a Journal of the British Diabetic Association
Maggie Shepherd

Abstract

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. 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. 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. Injecting insulin was integral to participants' lives ...Continue Reading

References

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Aug 4, 2006·The New England Journal of Medicine·Ewan R PearsonUNKNOWN Neonatal Diabetes International Collaborative Group
Apr 25, 2009·Diabetic Medicine : a Journal of the British Diabetic Association·M ShepherdA T Hattersley

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Citations

Mar 13, 2015·Diabetic Medicine : a Journal of the British Diabetic Association·A R BosmaL Henneman
Feb 14, 2012·Current Opinion in Endocrinology, Diabetes, and Obesity·Samir Malkani, Taniya DeSilva

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