Negotiating Moral Identity with Type 1 Diabetes: Care and Contradiction in Conversations with Young Adults

Abstract

This article is based on original ethnographic research among college students aged 18–25 living with insulin-dependent type 1 diabetes. I investigate how moral language in medical treatment settings and social environments informs patients’ experiences of managing their diabetes. Moral language about choice, control, responsibility, and risk was regularly used to describe daily diabetes management habits. Young adults with diabetes internalized a moral imperative to prioritize health. This moral obligation to health contributed to participants’ conceptions of self and influenced participants’ characterizations of other people with diabetes (PWD). Since the mid-twentieth century, the clinical approach to diabetes care has relaxed; however, some harmful assumptions linking patient character to his or her ability to comply with a prescribed treatment regimen still circulate in the culture of type 1 diabetes care. While failing to take insulin or to check blood sugars can lead to dangerously high or low glucose levels in the body, language tying patient worth to treatment compliance fails to show the complexity of striking a balance between hypervigilance and negligence in daily diabetes care routines.