For somebody with diabetes, whose disease management is so important in all these different aspects of their life, it’s impossible to form an identity without diabetes playing some part in that. For me, both as a person with diabetes and as a healthcare provider who takes care of people with diabetes, when I learned about this concept, it was really eye-opening for me. Hi, I’m Rebecca Vitale. I’m a behavioural diabetes researcher at the University of North Carolina in Chapel Hill. I’ve learned in my professional life the importance of diabetes identity. I’m also a person living with type 1 diabetes for almost thirty years. And so I think, from my personal experiences as well, I know how important this is in life with diabetes. Living with diabetes, it’s hard to encapsulate that into a single sort of quotable quote, because it really does impact every aspect of your life. From thinking about the foods you’re eating throughout the day, any physical activity that’s happening. It’s something that comes up and is important at many, many points throughout every day. And so living with diabetes really is an all-encompassing scenario. And there’s no way to sort of separate that from the other aspects of a person’s life. A person’s identity is their internal framework of who they believe themselves to be. And for somebody with diabetes, whose disease management is so important in all these different aspects of their life, it’s impossible to form an identity without diabetes playing some part in that. I think there are lots of different examples of how that can look. There are really adaptive ways of integrating diabetes into your identity, where it actually helps you in your diabetes management and forms a core part of your identity. But there are also more negative aspects of integration into identity that can interfere with diabetes self-management and make life with diabetes more challenging. When we’re thinking about our patients with diabetes, I think for many of them this is a concept that would likely resonate but may not necessarily be something that they’ve thought about in that context before. And so I think, this is a very new field. We’re just starting to think about the idea of diabetes integration into identity sort of as a field. So right now the research is more in the phase of describing the challenges and describing this phenomenon. And I think that over time we will learn more about how we can help people with diabetes with this idea of diabetes integration and identity integration. The biggest piece for now is as providers we can give people the language to talk about this and give them the space to think about it in our clinical visits and afterwards. So I like to think about it as giving a person the space to think about and reflect on that in a visit that will hopefully prompt them to continue thinking and reflecting over time. And that may prompt some internal reflection that could help them with their diabetes management. I think, down the road, we will have a lot more that we will learn about interventions that could help to support this from things like mindfulness to things like peer support. There’s a lot of ideas right now about what might be helpful for this. But we haven’t quite gotten to the place yet that we’ve studied those necessarily. I take care of both children and adults with diabetes. And when we think about the period of emerging adulthood, the 18- to 25-year-olds, the core developmental work of that stage of life is creating an identity for yourself, and figuring out who you are, and really forming and crystallising that identity. So I think that this is really a key aspect to think about for those 18- to 25-year-olds. And depending on the country, sometimes those people are seen in paediatric care, sometimes those people are seen in adult care. But I do think the roots of that identity start long before age 18. So I think it’s an important thing to think about and address in paediatrics care, but also the implications of that then extend far beyond the age of 18, far beyond the age of 25. And so, I actually think it may end up playing more of a role in adult care than paediatric care, although I think it’s important in both sides. For me, both as a person with diabetes and as a healthcare provider who takes care of people with diabetes, when I learned about this concept, it was really eye-opening for me. And so, I think some of it is just being aware that this exists, being aware that this idea of identity, this idea of diabetes integration into identity may be helping or may be challenging your patients in their diabetes management. That this is part of that whole sort of spectrum of somebody’s diabetes care. And so, thinking about it, acknowledging it, and potentially even just starting in a clinical visit to open up the space to say, I know that diabetes impacts every single aspect of your life. How does that work for you? What is that like for you? Are there places where that is really positive? Are there places where that’s really negative? I think, one important aspect of the diabetes identity integration is, of healthy identity integration, is being able to identify positive aspects of your disease, and find some positive from being a person with diabetes. And so I think, giving the people with diabetes the space to think about and reflect on those is really the first step and something that can be in the hands of every individual who takes care of people with diabetes.