Self-regulating blood sugar control in women with uncontrolled diabetes mellitus

Abstract

     The purpose of this study was to examine self-regulation of blood sugar control using the governmentality concept. Key informants were eight diabetic women with uncontrolled blood sugar levels in a community hospital. Semi-structured in-depth interviews and participatory observation techniques were used. Narrative analysis using Foucault's governmentality concept was applied for data analysis. The findings showed that the power of medical knowledge dominated the diabetic women's thoughts and directed their health practices. This had become the diabetic women's power for self-regulation. There were four patterns of self-regulation. 1) Surrendering and accepting: they accepted medical knowledge to manage their lives intensively, they surrendered their thoughts, and their bodies became docile; 2) Negoti- ation: disciplinary power was exercised more to control their bodies when the diabetes treatments were uncertain. They would be fearful, nervous and vague. Their health seeking process became a negotiation for managing their bodies without medical technology, for example, selecting alternative treatment. 3) Resistance: they sometimes resisted the dia- betes regulations because of their lifestyles and their cultural limitations in the role of housewives. They had to go through a process of trial and error until attaining a desirable blood sugar level that harmonized with their life-styles. 4) A conduct of conduct: the diabetic women were learning and sharing amongst themselves ways to control their blood sugar level and live their usual lives. The methods were experimental and applied without disclosure to the medical experts. Lay knowledge was created and transferred to others. Recommendations are that health care services should implement collaborative treatment which balances the power of medical knowledge and the power of the patient's self. Understanding self-regulation would enhance the patient's ability to control the blood sugar level and attain effective treatment.