Dramatic change in a young woman’s perception of her diabetes and remarkable reduction in HbA1c after an individual course of Guided Self-Determination

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A 24-year-old woman with type 1 diabetes participated
in a randomised controlled trial proving effectiveness of
a flexible Guided Self-Determination (GSD) intervention.
She had for 10 years been living with a complex
situation of eating disorder, poor glycaemic control, nonattendance
and psychosocial distress. She managed to
change her perception of diabetes dramatically and
improved her glycaemic control. Considering the
complexity of her case, we explored how she achieved
these changes. A GSD-trained nurse delivered the
intervention, which involves reflection sheets and
advanced professional communication. Glycated
hemoglobin was reported in the patient’s record and an
interview conducted by external interviewers was
analysed thematically, indicating that a four-stage
process of empowerment had taken place: ‘focusing on
life prior to numbers’, ‘unpacking a heavy burden’,
‘breaking out of isolation through communication’ and
‘finding strength within oneself’. The article emphasises
that GSD works by breaking isolation through
communication as an appropriate way to achieve good
diabetes control.
ArtikelnummerBMJ Case Rep 2015
TidsskriftBMJ Case Reports
Vol/bindPublished online
Sider (fra-til)1-5
Antal sider5
StatusUdgivet - 14 jun. 2015
Udgivet eksterntJa


  • diabetes