We hear a lot about diabetes research – mice being cured, islets being transplanted – but what about the other side of research. The bit looking at the practical side of how we deal with diabetes? Chloe Redshaw has been playing at being a pancreas for 20 years and is also studying for a Masters in Health Pyschology. We tied her to a chair and tortured her until she agreed to answer our questions about what she does.
Why did you decide to go into health psychology with a focus on diabetes?
I’ve had type 1 diabetes for 20 years and have had times of extreme difficulty with not just coping with self-care routines and glycymic control, but the psychological aspects of having diabetes. Feelings of denial, anger and sadness have all been a part of my journey to reach acceptance of my condition. I have had times where despite my best efforts to adhere to treatment regimes proposed by my healthcare professionals, my diabetes has still appeared to me at times to have a mind of its own.
All this has led me to believe that optimal control of diabetes is not just about administering the correct insulin, eating the correct food and monitoring my blood sugars, but the way I view myself as a person and how I view my diabetes as a condition. [The other reason I was so keen to interview Chloe is that I think she is spot on about this and so few people talk about it – Alison]
Ah, so diabetes…it’s all in your head. Discuss.
It would be foolish for anyone to suggest that diabetes (of any type) can be purely controlled by one’s own mind. However, we as humans are not robotic being purely driven by biological mechanisms. Our lives and our diabetes control are a result of an interaction of the biological body, the environment and our thoughts, feelings and personalities. A key example of this is stress. We all encounter situations that cause stress in our everyday lives and we all have a biological response that can cause increase in blood sugars. However, the way we respond and deal with these situations in our mind mediates this interaction between a situation and our biological response.
You’ve done some research into gender differences in diabetes. Obviously you’ll have discovered that women are superior, but other than that what did you learn?
This was specifically in adolescence, though I would be interested to also review the work done in adult diabetics. A prominent part of adolescence is gender identity formation. The review aimed to highlight the particular issues asthmatic and diabetic adolescents face and how they differ amongst males and females. These issues were found to be; social identities, personal feelings of self and representation of illness, talking about their illness with their peers, sport/exercise, diet, diabulimia, treatment regimes, conflict and sense of control. Gender does appear to impact substantially on the experience and management in adolescents with a chronic illness. Interventions and care should have considerations for how boys and girls respond and deal differently with their illness and the impact this can have. [So the research says we should be treating patients as individuals rather than putting them all through the same sheep dip, couldn’t agree more – Alison]
You went all modern and looked at whether text messaging reminders and encouragement to teenage diabetics made any difference. Did it?
Text messaging interventions proposes a way to integrate a diabetic health intervention into current adolescent culture. Studies vary in their methodology, varying between focusing on one particular issue and also whether the patient is a passive recipient or encouraged to interact with the text messaging system. Results show that studies focusing on attendance reminders are generally supportive but lack any evidence relating solely on adolescent diabetics. Other singular issues targeted such as blood glucose testing have been successful; however the problem of maintaining interest did arise.
A more interactive and personalised system has been introduced which enables multiple issues to be addressed; it appears to maintain interest relatively well over a 12 month period. Text messaging interventions for diabetic adolescents appears to be a viable and potentially inexpensive solution to enhancing the support that is already provided by primary care.
The above two pieces of work were focused on adolescent diabetics. However many of the issues addressed are still extremely relevant to diabetics of all ages.
What are you working on at the moment?
I’m currently working on a study exploring factors that influence HbA1C levels in diabetics. I am looking at factors such as; rumination, self-compassion, self-forgiveness, self care, self-esteem, stress and depression.
The study is centred around the self. For example; diabetes requires a high level of self-care and it can also lead to blame on the patient if their glycymic control is not good. However, I am interested to explore if high HbA1c levels can lead to a person having a lack of self compassion and forgiveness themselves. On the other hand I will look at if in fact it is a person’s trait of general lack of self-compassion and forgiveness, that in fact causes stress and increases HbA1c levels.
Is there anything we can do to help?
Finding willing respondents to research studies can be difficult, especially if there is no incentive to complete the questionnaire. In an ideal world I would offer everyone £100 to complete my survey. However, many researchers especially postgraduate do not have funding and would have to put their hand into their own pocket. Therefore, if you see advertisements for a study, please try and take the time to complete it. The saying really does go here; that every little helps!
Whilst I am on this note I would be extremely grateful if you could fill out my online study before 15 August 2011. It is a relatively short online questionnaire and I would really appreciate it!
Isn’t research like this a waste of time, surely we should all be focussed on a cure?
This is a completely understandable question that many may ask. First of all, it is important to note that psychological research into diabetes runs in parallel to the work towards a cure. Psychological work aims to enhance the day to day live of diabetics. It aims to help those with diabetes to live the best life that they can. This can be looked at in a variety of ways; from adjustment to diabetes life when first diagnosed to learning to successfully incorporate the illness into your identity without a negative impact on your psychological well-being. Psychologists are not capable of offering their time to find a cure, but are capable of offering their time to enhance diabetic’s lives, so why not utilize this?
And now, because we’re nosy, tell us about your diabetes…
How do you treat it?
I treat my diabetes just using my mind obviously! Seriously though…I inject long-acting insulin twice a day and my fast acting about 4 times a day. I am a little obsessed with checking my blood sugar so do that about 9 times a day. My doctor once said that it is too much and that maybe I should see a psychologist!
What’s your favourite hypo treatment?
Anything! I am like a wild cat when my blood sugars is low..literally want to eat anything!
Tell us your most embarrassing hypo story…
Hmmm. I was in Spain once walking around a festival. There were big statues and banners etc being carried through the street and I started thinking they were all coming towards me and getting really paranoid. I initially thought someone had drugged my drink and proceeded to get myself into a complete panic. Then I stopped for a moment, checked my blood sugar and of course it was 1.5! After a heap full of sugar I realised that the statues were not coming to attack me and I was safe!
And so we finally untied Chloe from her chair and released her back into the wilds of diabetes research on the condition that she comes back to share the results of her work with us. If you haven’t already, please take a minute to fill out her survey – we can’t complain about a lack of decent healthcare if we’re not willing to put a bit of time into supporting the academic work looking at how to improve it.