Do Insulin Pumps Effect Body Image & Self-Esteem?

We are proud to announce that, after years of hard work, new Kovler Team Member Ashley Tullman just successfully defended her doctoral dissertation on the effects of insulin pumps on body image and self-esteem. Ashley’s passion for treating the psychosocial implications of chronic illness in children, adolescents and their families make her a fantastic addition to Kovler’s Individual and Family Wellness Program.

Congratulations, Ashley, and welcome to the Kovler Team!

Here Ashley shares with us the basics of her fascinating research.

Doctoral Dissertation:
A Phenomenological Study of the Psychosocial Effects of Insulin Pump Therapy on the Body Image and Self- Esteem of Female, Adolescent Insulin Dependent Diabetics

Ashley J. Tullman, M.A.

The recent increase in prescription of insulin pumps for daily diabetes care has lead to an increase in control and positive medical advancements. “[Insulin pump] use has increased dramatically, from 15,000 patients in 1993 to over 81,000 patients in the US at the end of 2000” (Bode, 2002, p.S14). It has been well researched and documented that the insulin pump provides better glucose level control in type 1 diabetes when compared to injection therapy. This being said, there is limited research to this point as to how the expanding prescription of insulin pumps to the adolescent population, specifically females, may be affecting their psychological development at this crucial period. Research has shown the female adolescent population to be highly prone to body image and self-esteem issues regardless of compounding factors such as wearing an insulin pump (Battaglia, 2005).

The specific objective of this study is to produce a partial life course description of the meaning and experience of wearing an insulin pump for adolescent women. Further information as to their struggles, their needs and their own priorities were assessed. The three main research questions were: (1) What are the psychosocial effects of wearing an insulin pump on adolescent girls? (2) What specific struggles are there as they relate to the body image and self-esteem of this group? (3) Are primary care physicians and endocrinologists addressing the psychological impact on day-to-day life?

12 participants between the ages of 12-28 were given a semi-structured interview which provided the solid grounding needed to ensure a common basis to the interactions but allowed for additional knowledge to be gained through personal interaction with each individual. The hope was to gather not only an understanding of each individual, but also an overall group experience, essentially, “how human beings make sense of experience and transform experience into consciousness, both individually and as a shared meaning” (Patton, 2002, p. 104). Meaning units were interpreted from the results and major and minor themes emerged. The major themes were an increased level of maturity seen among all participants, increased awareness of one’s body, and a positive reflection on increased flexibility in their daily lives gained through wearing an insulin pump. The minor themes included: more control afforded by the pump, struggles with relationships, varied self-esteem, and a lack of societal awareness. The results of this study suggest that the insulin pump is an overall positive addition to diabetes care for adolescent females in terms of their psychosocial health. However, the results also reflect an overall lack of and need for social and psychological support for this cohort. While there were some negative and concerning factors present, the overall reflection on daily life with an insulin pump was positive.