In both clinical and commercial contexts, wearable medical devices now off er a wide and growing range of diagnostic, therapeutic, and monitoring capacities. In diabetes, glucose-monitoring sensors and insulin infusion pumps have revolutionised self-care by drastically increasing the ability of patients to respond to their changing blood glucose concentrations. However, in common with many medical wearables, such devices are often bulky and uncomfortable to wear, and can be time-consuming to use and maintain. Moreover, since medical wearables such as insulin pumps are frequently visible to others, their aesthetic characteristics are important but often overlooked aspects of long-term use. Although the world of fashion and design might seem far removed from the complexities of medical wearables, recent developments in diabetic technologies and associated garments highlight the increasingly productive synergy between these two spheres. This development is of particular importance in view of the enduring social stigma arising when people who do not have diabetes attribute negative characteristics to people with diabetes—for example, identifying them as sickly, incapable, selfindulgent, or otherwise responsible for their disorder. Personal stigma, or self-stigma, arises when people with diabetes attribute these negative characteristics to themselves. When acted on, both kinds of stigma can lead to negative experiences, such as workplace discrimination against people with diabetes and concealment behaviours on the part of those with diabetes (eg, delaying insulin injections). In turn, these phenomena can result in suboptimum blood glucose control and clinical complications, in addition to heightened levels of psychological distress. Wearable diabetes technologies are implicated in this fi eld of psychosocial experience, since they can signal the presence of diabetes to others (eg, through visibility or audible alarms) while simultaneously reminding the wearer of their own disorder. In this context, some people with diabetes have sought to challenge stigmas through visibility itself, an approach that places medical aesthetics front of stage. One of the best known examples of this approach took place during the Miss Idaho beauty pageant in 2014, when Sierra Sandison wore her insulin pump during the swimsuit catwalk. Sandison shared a photograph of the moment on social media together with the hashtag #showmeyourpump, prompting thousands of others to share images of their own pumps. By bringing her wearable device into the fashion world, Sandison challenged stigmas associated with diabetes and diabetic devices. Speaking in 2014, she stated: “My message to everyone, diabetic or not, is that we all have something that doesn’t measure up to the beauty standards set by the media—and that is ok. It does not make you any less beautiful.” In addition to challenging stigma through visibility, many people with diabetes have also sought to make a virtue out of necessity by personalising their devices in aesthetically pleasing ways. Several companies now off er products with which individuals can customise their devices, such as Pump Peelz adhesive stickers, which can be placed over insulin pumps to make them more colourful and attractive. Other companies such as Pump Wear and Pump Boutique also feature a range of garments and jewellery for people with diabetes, and designer Jessica Floeh’s Hanky Pancreas range off ers women a variety of clothing and accessories with which to personalise or camoufl age their wearable devices. Device manufacturers are also seeking to develop more attractive sensors and pumps. For example, the t:slim insulin pump is marketed as “the slimmest pump on the market”, with a “sleek, modern design”, enabling it to “be worn discreetly under clothing”. By augmenting the aesthetic aspects of living with diabetes, these innovations might help to challenge social and personal stigmas. Moreover, as smart clothing (garments with embedded digital functionality) becomes more sophisticated and powerful, there is scope for high-fashion pieces to raise awareness and challenge diabetes stigma in artistic circles. Designers such as Anouk Wipprecht have already incor porated electroencephalo graphy and electrocardiography tech nologies into captivating smart dresses, and there seems no reason why an eye-catching diabetes dress could not be designed with glucose-sensing capacities instead. Thus, whether in terms of high fashion or everyday experience, there is clearly an important role for future collaborations between diabetic technology and the seeming ly distant world of fashion and design—collaborations that might help to alleviate the negative eff ects of diabetic stigma at both social and personal levels.
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Open Access
Apr 1, 2018
Diane K Wherrett + 5
