Family Voices at the Table in Type 1 Diabetes Mellitus: A Dialogical Perspective on Food Management

Type 1 Diabetes Mellitus (T1DM) is a health condition that requires careful management of food intake to prevent health crises and complications. Previous research has primarily focused on clinical indicators and treatment adherence, leaving family dynamics largely unexplored. Drawing on the intersection between Cultural Psychology and Dialogical Self Theory (DST), this study seeks to understand how meanings about food management are configured within the family of an adolescent diagnosed with T1DM. An idiographic, qualitative approach through an in-depth case analysis is adopted. Fieldwork combined 1. A semi-structured situated task based on everyday activities of purchasing, preparing, and consuming food, and 2. Individual semi-structured interviews. Findings indicate that family meanings about food management are configured as a semiotic, dialogical, and affective field, sustained by the continuous negotiation among family voices; by collective affective regulation, by the displacement from family to intimate bodily dialogue, and by the reorganization of I-positionings involving continuity, change, and conflict. These results may extend DST by showing how the voices that constitute the experience of the Self can emerge from the body, affectively shaping both the family and personal experience of food management in T1DM. Practical implications for interventions that integrate the patient’s family are discussed.