The purpose of this grounded theory study was to investigate the experience of living with insulin-dependent diabetes mellitus. Data were collected from interviews with four participants, and from their diabetes papers and journals. This article summarizes the results of the data collection and presents implications for diabetes educators. The results challenge the traditional compliance/adherence paradigm within which current diabetes education programs operate and provide evidence of the need to move to a new integration paradigm. The new paradigm would replace adherence relationships with collaborative alliances between clients and educators and encourage educators to practice empathy as a way of knowing.

Diabetes among First Nations peoples has reached epidemic proportions, and diabetes prevalence, complications, and mortality rates are higher than in Whites. The purpose of this grounded theory study was to investigate the experience of Type 2 diabetes in First Nations adults. Ten individuals living in one reserve community, in southwestern Ontario, participated in this research. Participants were interviewed on two occasions by a First Nations nurse. All interviews were audiotaped and transcribed verbatim. A three-phase process of integration emerged, similar to the process of integration discovered in prior research with Type 1 diabetic Whites. However, there were some important differences in the characteristics of these three phases. In addition, there were surprising findings related to beliefs about the type of diabetes educator desired by these First Nations clients.

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People with diabetes should be encouraged to identify their own body cues that signify different levels of glycemia because these personal cues may be different than classical textbook symptoms. Even people with hypoglycemia unawareness may recognize unique cues that replace the autonomic ones they have lost.

Diabetes educators use theories all the time, even if they are not aware of it. To teach, one must have some assumptions about how people learn and what constitutes effective teaching. The purpose of this article is to help diabetes educators interested in research and evaluation choose appropriate theories. The article will review the 4 purposes of theories, that is, description, explanation, prediction, and control, as well as the degree to which a theory has been articulated and elaborated. The importance of a theory's personal resonance, its explanatory power, and its utility will also be examined. The article will also review how to use 1 or more theories at each stage of a research or evaluation project.