Culture, Medicine and Psychiatry

, Volume 24, Issue 4, pp 379–401 | Cite as

Interpreting Diabetes Mellitus: Differences between Patient and Provider Models of Disease and their Implications for Clinical Practice

  • Ron Loewe
  • Joshua Freeman


Current medical literature suggests that Type 2 diabetes mellitus can becontrolled by diet and hypoglycemic agents or diet and insulin therapy.Nevertheless, adhering to a low glucose dietary regimen remainsproblematic for a majority of patients, and management of the disease isan ongoing source of frustration for physicians and other providers.While calling for more research on the physician's experience oftreating chronic conditions like diabetes, the authors argue that muchof the current frustration stems from the different frames orexplanatory models that physicians and patients use to understand thedisease. By comparing physician narratives collected in several clinicalcontexts (e.g., medical lectures, precepting sessions, patient caresessions and personal interviews) with patient stories obtainedprimarily through narrative interviews, the authors highlight crucialdifferences in the way physicians and patients experience and thinkabout the disease. In particular, the authors highlight differencesbetween physicians and patients across five dimensions: etiology,symptoms/signs, factors which affect blood sugar, ideal blood sugar,and future prospects. In concluding, the authors sketch out elements ofa theory of clinical practice involving diabetes care. Data for thestudy was collected at two family practice training sites in Chicago.

diabetes chronic illness experience medical models narrative doctor–patient relations 


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Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Ron Loewe
    • 1
  • Joshua Freeman
    • 2
    • 3
  1. 1.Department of Sociology, Anthropology and Social WorkMississippi State UniversityU.S.A.
  2. 2.Department of Family MedicineUniversity of TexasUSA
  3. 3.Health Science CenterSan AntonioU.S.A.

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