Hi cureforbedbugs

I think that you make some excellent points so I have reblogged your post.

As a partner of someone who is pre-diabetic and at risk due to a family history this is something dear to my heart.

I think that this sort of approach can be useful for some people but thank you for pointing out some clear dangers




Through app, diabetes is gamified as a monster to be tamed

mySugr makes it more fun for diabetics to monitor and treat their condition by treating it as a virtual monster that reacts to their actions.

Full Story: Springwise

As someone whose anxiety disorder is very intimately connected to an obsession with blood sugar levels, this strikes me as a potentially catastrophic idea for a lot of people.

Diabetes management does not (necessarily) benefit from trying to control blood sugar completely at all times. It’s an odds game — lower A1C’s and lower post-meal spikes seem to generally level the playing field in terms of complications. The idea that diabetes management is not a challenge of controlling the minutiae in your everyday life but rather a broad set of strategies you use to remain healthy is kind of a microcosm for pathologies of management of chronic (or “chronic,” as when people are “diagnosed” with things that are not actually diseases — like, you know, being healthy and fat at the same time) conditions.

When you look at the flipside of this, that obsession with one’s well-being is pretty closely aligned to anxiety, depression, and related conditions that will end up fucking you up way worse than diabetes alone — since on top of the basic harm they also worsen the diabetes management — you have to start weighing the pros and cons of being too worried about your day to day management. You need to learn to forgive yourself and not trust what cognitive therapists would call “catastrophizing” — imagining that every false move can be extrapolated to your own death, say.

Diabetes isn’t a “monster.” You deal with it, and you try to get better, and you don’t get obsessed with tracking every little detail. It’s not something that needs “gamification,” it’s something that needs an approach that values body and mind as connected things, as opposed to, you know, your body being a bad guy you need to kill.

I just watched the video from the designer, who is a type I diabetic himself (I never got to meet my grandmother, because no one knew how to treat her type I diabetes when she was alive). 

I want to go easy here, because there’s a lot of love built in, and the designer has worked hard and earnestly to make something that’s meaningful to him.

But I have to agree strongly with cure, above. I know people who have to deal with chronic health conditions, and the overall goal is not to add cognitive load to that management. I know the books and webinars this developer has gone through to arrive at this particular strategy, but those are mostly sold to him by purveyors in 21st c. snake oil. It might be oil, and it might come from snakes, but it will not heal your app.

The MySugr developer added points, feedback, and additional demands to a complex system of health management. Those aren’t what will make it funner, easier, more playful, or more meaningful. They will make it more demanding — as cognitive consideration and as actions to undertake.

This can work — we do things that are difficult all the time, like play chess, or Words With Friends, or whatever. But this is none of those, and it’s not the point systems in either one that makes them meaningful. 

Further, to the points made above, this presents the condition as something to oppose, rather than something to metabolize and live in dialogue with. This is serious stuff, and if it can be made playful, make it playful. But not by treating the condition of your body as an enemy to conquer, and not by fighting it with baroque checkins, points and missions.

Think about the behavior you want to encourage, and think about what might produce that behavior. If you want it to be playful, it might not take diabetes as its nominal subject. It could be about anything fun in the world. The only criterion should be that when you engage with it, you change your behavior — or mindset —  in order to do so. Lots of playful systems do that: soccer changes how you interact with people around you, tetris changes how you see the world, and the nike fuelband works precisely because it is neither precise nor prescriptive.

I don’t mean to discourage such an earnest approach, except that the earnestness of it is exactly where it falls short. I hope to see health-related efforts in the future that have genuine playfulness in their beating heart.