Techno-social reconfigurations in diabetes (self-) care

This article focuses on the ways in which a flash glucose monitoring system, FreeStyle Libre®, is introduced and used by people living with type 1 diabetes, their relatives and healthcare professionals. It draws on a multi-sited ethnography in a variety of clinical and daily situations, and on interviews with caregivers and people living with diabetes. We explore how the users develop knowledge-in-practice, and consider the use of self-management technologies to be largely dependent on locally grounded and situated care acts, and resulting from the relational, pragmatic and creative maneuvering of technology-in-practice. Our findings show that adjustments between users, their bodies and the technology are required, and show the reflexive work and practices of patients and relatives who learn to use the device in a proper way. Moreover, we reveal that practitioners see this technology as a tool that not only improves self-care practices but also clinical practices, and that wearing and using this new medical device may become a moral injunction for self-improvement. Our results illustrate the techno-social reconfigurations at work and the development of new ways of feeling, thinking and acting in diabetes (self-) care

Une technologie qui redistribue l’attention : travail d’appropriation d’un outil de gestion du diabète de type 1

La technologie occupe une place cruciale dans la division du travail entre les personnes vivant avec un diabète et les acteur·rice·s impliqué·e·s dans leur prise en charge. Au cours d’une recherche ethnographique menée en Suisse, nous avons étudié les usages des technologies dans la gestion du diabète au sein de larges réseaux de soin impliquant différents sites de prise en charge. À la suite des nombreuses recherches issues des STS prenant pour objet les technologies et les maladies chroniques, notre article souligne les mécanismes d’appropriation d’une nouvelle technologie et la manière dont elle façonne les interactions entre soignant·e·s et soigné·e·s, reconfigure leurs connaissances et pratiques respectives et redéfinit les relations de care. Nous documentons ainsi la manière dont les technologies – et plus particulièrement le FreeStyle Libre – reconfigurent l’attention que les personnes portent à l’évolution de la glycémie, qu’elle soit la leur, celle d’un·e proche ou d’un·e patient·e.Technology plays a crucial role in the division of labor between people living with diabetes and the actors involved in their healthcare. During an ethnographic study conducted in Switzerland, we have investigated the uses of technologies in diabetes management within large networks of care involving various sites. Following the numerous STS research studies on technologies and chronic diseases, our paper highlights the mechanisms of appropriation of a new technology, and the way it shapes interactions between caregivers and care receivers, reconfigures their respective knowledge and practices, and redefines care relationships. We thus document how technologies, and specifically the Freestyle Libre, reconfigure people’s attention to changes in glucose levels, whether it is their own or that of a relative or a patient

Une technologie qui redistribue l’attention : travail d’appropriation d’un outil de gestion du diabète de type 1

Technology plays a crucial role in the division of labor between people living with diabetes and the actors involved in their healthcare. During an ethnographic study conducted in Switzerland, we have investigated the uses of technologies in diabetes management within large networks of care involving various sites. Following the numerous STS research studies on technologies and chronic diseases, our paper highlights the mechanisms of appropriation of a new technology, and the way it shapes interactions between caregivers and care receivers, reconfigures their respective knowledge and practices, and redefines care relationships. We thus document how technologies, and specifically the Freestyle Libre, reconfigure people’s attention to changes in glucose levels, whether it is their own or that of a relative or a patient

Learning to manage diabetes using a flash glucose monitoring device at a summer camp: A collective appropriation process

Self-management of type 1 diabetes (T1D) is a difficult task that involves different actions and decisions and requires various types of knowledge. Nowadays, it can be done partly autonomously, using a mobile digital device that measures the level of blood glucose. The FreeStyle Libre, launched on the Swiss market in 2016, is one such device. Drawing on Science and Technology Studies and adopting a sociocultural approach to learning, the present study investigated how healthcare professionals and young people living with T1D learned to use this new device during a summer camp. Based on field observations and interviews, results showed that through the mediation of others, an appropriation space was created. Through distributed expertise involving different actors, practices and types of knowledge, the users learned technical and procedural knowledge, and much more besides. In particular, they learned to cope with uncertainty, sidestep obstacles, and trust the device, gaining knowledge about diabetes itself in the process and grasping the potential contribution of the new data provided by this device to therapeutic decisions. By drawing on an explicit theory of learning that considers learning to be a context-bound activity, the present study will inspire the development of new practices in health education

Matérialités soignantes : les technologies du care en santé

Quelle est la place des technologies de santé dans le soin ? Faut-il opposer la froideur distante des médiations instrumentales du cure à la proximité chaleureuse des relations humaines du care ? En quels sens peut-on dire que les dispositifs sociotechniques de plus en plus complexes, omniprésents dans le domaine sanitaire, contribuent à redéfinir les relations de soin (soin de soi et d’autrui) ? En se positionnant au croisement de l’anthropologie de la santé et de l’anthropologie et de la sociologie des sciences et des techniques, ce numéro vise à montrer de quelle manière l’étude des équipements et des pratiques matérielles constitue une entrée féconde pour comprendre les sens du soin dans les mondes contemporains de la santé. Abordant des contextes sanitaires diversifiés, les contributions réunies ici mettent en lumière non seulement le fait que les technologies peuvent être intégrées à des relations et des pratiques soignantes, attentives et singularisées, qui passent par elles, mais aussi que le soin vient aux technologies par un travail collectif, fait d’ajustements, de négociations, d’appropriations, non dépourvu de tensions et d’ambivalences, qui les produit comme autant de matérialités soignantes. What is the place of health technologies in care? Should the distant coldness of the instrumental means of cure be strictly opposed to the warm proximity of human relations of care? How do the increasingly complex socio-technical devices, omnipresent nowadays in the healthcare field, contribute to redefining the relations of care (care of oneself and care of others)? This issue, positioned at the crossroads of the anthropology of health and the anthropology and sociology of science and technology, aims to show that studying equipment and material practices constitutes a rich entry point to understanding the meanings of care in contemporary health worlds. Addressing various health contexts, the contributions gathered here highlight not only the fact that technologiesusedcan be fully integrated into attentive and personalized care relationships and practices, but also that the care comes to technologies through collective work, made of adjustments, negotiations, appropriations, not devoid of tensions and ambivalences, which gives rise to many material dimensions of care