Diabetes self-management: Multiple technologies of self

Self-management is now positioned as essential to the optimal management of many chronic diseases. Health promoters and service providers often acknowledge that some forms of self-management are difficult and demanding, and that health education must be appropriately tailored in order to enhance "compliance". These discourses may recognise that part of a person's response to diagnosis arises from the individual's personality and their social circumstances. However, less attention is paid to the social and personal effects of the variety of strategies people deploy in order to manage an ongoing condition. Self-management affects more than symptoms or disease status; it also shapes the subjectivity of the person, so different management strategies may mould different selves. The self-management of diabetes entails numerous daily practices, and produces several distinct ways of constructing an embodied diabetic self. In this article, I describe how a sample of adults living with diabetes type 2 manage their diabetes from day to day, and how those activities both arise from, and contribute to, distinctive subject positions. Appreciating the daily and dynamic character of self-management may also help service providers to facilitate an improved quality of life for people with chronic conditions.