I Have Diabetes, Therefore I Am?

Can having a chronic disease define who you are?

Having a chronic disease like type 1 diabetes has a huge impact on the patient’s life. How young people integrate that impact into their own self-perception can color their psychological and physical health.

Using a tool called the Illness Identity Questionnaire, Leen Oris, PhD, at the Faculty of Psychology and Educational Sciences at the University of Leuven in Belgium, along with colleagues from Ghent University in Belgium and the University of Gothenburg in Sweden, surveyed 575 adolescents and young adults between 14 and 25 years of age who had type 1 diabetes. They looked at four dimensions of identity: engulfment, rejection, acceptance, and enrichment. They also asked about psychological functioning, diabetes-related problems, adherence to treatment, and from their medical records, HbA1c values.

Each dimension did have meaningful differences in health outcomes, they found.

Rejection was associated with worse treatment adherence and higher HbA1c levels while engulfment was linked with less adaptive psychological functioning, and more diabetes-related problems.

Conversely, acceptance was associated with more adaptive psychological functioning, fewer diabetes-related problems, and better adherence to treatment. Enrichment was related to more adaptive psychological functioning.

“The present findings underscore the importance of the concept of illness identity. A valid and reliable measure, the IIQ, is introduced to measure four illness identity dimensions in individuals with type 1 diabetes. These four illness identity dimensions were uniquely related to psychological and diabetes-specific functioning,” the authors wrote in the May 2016 issue of Diabetes Care.