Framings of Patient Knowledge and Proximal Technologies in Type 1 Diabetes: A Hermeneutic Review Using Meta‐Narrative Methods

Abstract

ABSTRACT Some people living with type 1 diabetes (T1D) wear glucose sensors and pumps which use algorithms to deliver insulin automatically. These technologies require practical knowledge, yet how patients develop this knowledge remains undertheorised. We conducted a hermeneutic review, informed by meta‐narrative methods, to examine how different research traditions have conceptualised patient knowledge concerning T1D proximal or wearable technologies. Using databases and snowball searches, we classified 74 articles into four research traditions, each carrying assumptions about how patients acquire, develop or enact knowledge. In biomedical literature, patients were typically seen as passive recipients of technology, with knowledge framed as factual or skills‐based. Health psychology literature emphasised individual empowerment through mastery of technical skills. Design and innovation studies treated patient knowledge as an instrument for design. Social science‐informed approaches focused on knowledge as a social process distributed between patients through communities of practice or centred on enacting embodied and situated knowledge. Our review shows how narrow framings risk undermining the richness of T1D knowledge practices with implications for technology development and implementation in the context of diabetes care. We argue for stronger engagement with sociologically informed approaches in future research to attend to the multiplicity of knowledge practices.

The authors' abstract, as published at the source. Sociology of Health & Illness, 2026 · DOI ↗