|Title of host publication||The Wiley-Blackwell Encyclopaedia of Health, Illness, Behaviour and Society|
|Publication status||Accepted/In press - 1 Mar 2023|
Diabetes has become a major public health challenge globally and is projected to rise dramatically. This paper examines the barriers that prevent optimal glucose control, and why public health interventions need to consider them. Little is understood about the uptake of these interventions and why lifestyle change has been so difficult to achieve. The arguments are divided into four parts. The four sections represent recent sociological research in diabetes focusing on current debates in the way people living with diabetes negotiate their illness journeys. First, the paper explores the ‘pre-diabetes’ phase where people fail to make lifestyle changes in the context of increased risk of developing diabetes; where public health should re-consider how the public understand and respond to ‘risk’. Second, the tension between leading a normal life or maintaining family function is examined, in the presence of diabetes symptom control, a challenge that often leads to sub optimal disease control. Third, ‘Body projects’ are examined in relation to how people align glucose control regimes with gendered identity stereotypes. Fourth, the paper shows how different illness contexts impact on self-management, often limiting people’s ability to control their disease optimally.