Thirty interviews conducted by Stuart Bradwel as part of the Wellcome Trust-funded PhD studentship at the University of Strathclyde ‘Doctors Orders’ – Type 1 Diabetes and the Consultative Relationship, 1965-2002.
Whereas early physicians approached Type 1 Diabetes Mellitus (T1DM) in the paternalistic fashion common to mid-twentieth century practice and expected strict obedience to prescribed treatment, in 2002 the Dose Adjustment for Normal Eating (DAFNE) programme was initiated. This reconceptualised the professional as a remote source of support while encouraging those with T1DM to take an active role in determining the character of treatment, adjusting their own dosages of insulin and dietary intake as necessary on a day-to-day basis. Consequently, the traditionally passive ‘patient’ was transformed into a legitimately meaningful actor with the power to refine therapy according to their own subjective values and priorities.
The project investigated the nature of this transition from physician- to patient-led care in orthodox T1DM management, making particular reference to a process of ideological evolution within the medical profession in light of growing evidence that an empowered patient-body led to superior clinical outcomes. There is little printed evidence concerning the lay-experience of T1DM, while professional volumes tend to be heavily editorialised. Consequently, oral history – from both those with T1DM and professionals – was identified as a promising methodological framework with considerable potential to produce valuable evidence. A total of thirty interviews (19 with people living with type 1 diabetes, 7 with healthcare professionals, and 4 with professionals with the condition) were conducted between 5th May 2017 and 3rd July 2019.