Rentschler, Carrie, and Benjamin Nothwehr. 2021. “Transmitting Insulin: The Design, Look, and 
Performance of Insulin Delivery Devices as Communication Technologies.” Catalyst: Feminism, 
Theory, Technoscience 7 (1): 1–36. 

http://www.catalystjournal.org | ISSN: 2380-3312 

© Carrie Rentschler and Benjamin Nothwehr, 2021 | Licensed to the Catalyst Project under a 
Creative Commons Attribution Non-Commercial No Derivatives license 

 

                                                                                                                                             

 

 
Transmitting Insulin: The Design, Look, and 
Performance of Insulin Delivery Devices as 
Communication Technologies  

 

Carrie Rentschler   

McGill University 
carrie.rentschler@mcgill.ca 
 

Benjamin Nothwehr 
McGill University 
benjamin.nothwehr@mail.mcgill.ca 

 
 
Abstract 
In this article, we examine how insulin pens and pumps – two major devices for 
delivering insulin, the anabolic hormone used to treat Type 1 diabetes – are 
designed to conceal and fashion insulin delivery around their appearance as key 
communication technologies. Insulin pens and insulin pumps transform the 
aesthetics of insulin delivery away from the medicalized appearance of syringes 
toward that of beautiful technological artifacts. They both hide and draw 
attention to their status as technological artifacts and their medical use through a 
set of desirable, though sometimes incongruous, device aesthetics. Deliberately 
marketed around their resemblance to pens or pagers, insulin delivery devices are 
examples of skeuomorphs that “materialize the metaphor” of writing instruments 
and telecommunication tools into their design. We analyze how diabetes 
education and marketing materials present insulin delivery devices through 
skeuomorphic performances of use that uphold norms of concealment in diabetes 
self-management in conditions of social and medical surveillance. Drawing on 
patents, educational and marketing materials, and our own experiences with 
these devices, we argue that the skeuomorphic design of these devices morally 
regulates the embodied performance of diabetes. 



 
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Introduction 
Since the discovery of insulin in 1921, the treatment of type 1 diabetes has largely 
revolved around the injection of this anabolic hormone, which enables food to be 
broken down into energy that is usable by the body. Insulin allowed diabetics1 to 
finally evade, or at least significantly delay, what had been known throughout 
much of human history as a death sentence of variable length. Before the mid-
1980s, the hormone was injected via syringe and, although a variety of other 
delivery devices exist today, many people with diabetes continue to use syringes 
to deliver insulin on a daily basis. Tiny glass bottles of insulin and orange-capped 
syringes have come to stand in as visual symbols of diabetes. Perhaps more than 
any other medical object associated with the treatment of diabetes, the boundary 
object of the syringe brings the disease into legibility at the very moment of 
insulin delivery (see Star and Griesemer 1989; Star 2010). Drawing attention 
through its symbolic and performative dimensions, the syringe-as-boundary-
object inscribes visible difference onto diabetic bodies, in ways that contemporary 
insulin delivery technologies have significantly transformed, and, in some ways, 
reproduced.     
 
While a syringe and a vial of insulin very clearly mark the public performance of 
injecting insulin as an unmistakably medical one, more recent technologies such 
as insulin pens and insulin pumps enable diabetics to wear and use their insulin 
delivery devices as if they were common communication technologies. Insulin 
pens are designed to look like fancy and fun writing instruments, while insulin 
pumps have been designed to look like pagers and, increasingly, cellphones and 
smartphones, depending on the brand. Deliberately marketed as resembling pens 
or pagers, insulin pens and pumps share aesthetic design features with these 
communication technologies that help to conceal their function and use as 
medical devices. Combining designs for discretion and fashion, several aesthetic 
features also draw attention to these medical devices as beautiful objects to be 
looked at and handled, thereby enabling type 1 diabetics to manage and even 
obscure visible signs of their medical use, as disability scholar Graham Pullin 
(2009) analyzes in relation to assistive technologies for the disabled. They also 
communicate, and are used to communicate, socially sanctioned codes of 
behavior that govern how diabetics treat their disease and care for themselves in 
public, echoing Alison Kafer’s (2013) insight that “neither assistive technologies 
nor our uses of them are ahistorical or apolitical” (120).  
 
While certainly medical in purpose, and in some cases designed for disability, 
these technologies also play a communicative role both through their material 
design and their semiotic functions, in at least two other ways. Resembling 
ubiquitous communication technologies, they physically transmit insulin into the 
diabetic body: their A61M 5/00 patent classification identifies them as “devices 
meant for introducing media into the body in a subcutaneous, intravascular or 



 
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intramuscular way” (Cooperative Patent Classification 2020, 37). In addition to 
their ability to transduce media (insulin) into bodies, they also communicate 
through sound, image, and haptics, providing audible and tactile cues for those 
who are hard of seeing and hearing. Insulin pens “click” to signal standardized 
dosage amounts, while pumps offer vibrational alarms and touch-enhanced 
button pushes, along with other design features for disability. When we say insulin 
pens and pumps “communicate,” we mean in all three of these senses of 
communication. Our analysis will focus most centrally on how the devices signal 
information to users that shape the ways in which diabetics manage the 
embodiment of their diabetes in social contexts.   
 
As Stephen Horrocks (2019) reminds us, type 1 diabetics are in “medically 
compelled human–technological relationships” (1). As medically necessary 
technologies, our diabetes devices enact what non-diabetic bodies would 
otherwise do biologically. We delegate to our technologies the tasks of measuring 
the amount of sugar in our bodies for the purposes of adjusting it, and providing 
insulin, which a non-diabetic pancreas would produce and adjust itself (Akrich 
1992, 218; see also Latour 1988). As such, diabetics routinely engage with medical 
technology to satisfy two major facets of their disease management: testing 
blood glucose levels and administering insulin doses. We are able to test our blood 
sugar using blood glucose meters and continuous glucose monitors, the latter of 
which attach to our bodies and communicate wirelessly to mobile phones and 
insulin pumps through radio frequency. Insulin delivery occurs via syringe, insulin 
pen, or insulin pump, or a combination of these devices. Insulin dosages are 
determined by a variety of factors, including our blood sugar levels and the 
amount of carbohydrates we eat. 
 
Diabetes is a way of doing chronic illness. It is not only a condition we have, it is 
also something we do, as sets of practices we engage through relationships with 
technology and medical instruments, and systems of quantification and insulin 
delivery (see Mol and Law 2004). Annemarie Mol and John Law (2004) explain 
that we do diabetes by measuring blood sugars, feeling the effects of low and high 
blood sugar and countering them, and delivering insulin, among a range of other 
embodied and highly technologized actions (50). In these processes of doing 
diabetes with technology, we are subject to norms of surveillance that are, in turn, 
embodied in technologies of insulin delivery and glucose measurement and our 
uses of them. Around these technologies, the discourses used to market and 
promote them enact the cultural and social enforcement of diabetes care and 
treatment as we perform it.  
 
In this article, we analyze how insulin pens and pumps are designed and marketed 
to diabetics in terms of their ability to both conceal and render their diabetes 
visible, and thus legible, in the moment of insulin delivery. To do so, we identify 
and examine a set of patent designs, marketing materials, and medical 



 
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association promotional materials concerning insulin pens and pumps that are 
directed at type 1 diabetic users. Patent applications for insulin pens and pumps 
illustrate how codes of classed and gendered comportment appear in designs for 
and explanations of the devices and what users can do with them. The 
applications reveal how patents embody “a relation between knowledge and 
materiality” that get enshrined in property rights around technologies (Biagioli 
2014, 384). We focus on the ways these applications diagram the technology and 
textually explain its operations and use. Other documents we analyze include a 
multi-page brochure for one of the first major insulin pens on the market, the 
NovoPen®, and archival photographs of the pen’s design, both of which are 
housed at the Smithsonian National Museum of American History, in their 
Division of Science and Medicine, in Washington, DC.2 The archival photographs 
visualize the patented devices brought to market; they also locate the technology 
in a US national history of technological innovation and demonstration (see 
Pottage 2011, 623). The 1986 brochure serves as a key document in our analysis, 
as it represents the ways NovoPen® introduced this newly designed technology to 
potential consumers. We also examine online promotional brochures from insulin 
pump manufacturers, in which pumps are presented as lifestyle technologies 
alongside other communication technologies; and official Diabetes Association 
patient information from Ontario, Quebec, the US, and the UK that present 
insulin pens and pumps as being like fountain pens and pagers, respectively. The 
latter set of documents demonstrate how comparisons between insulin delivery 
devices and communication technologies have been standardized across national 
and provincial professional diabetes education sources, illustrating how the 
boundary object status of insulin pens and pumps—in place of the syringe—have 
been transformed into standards of device design (see Star and Ruhleder 1996; 
Star 2010, 614). We also demonstrate how these standards appear in magazine 
articles directed at audiences of diabetics, which review insulin pump designs 
around their aesthetic features and designs for disability (see Diabetes Forecast 
2019).  
 
These documentary materials reveal how insulin delivery devices are designed 
and promoted as technologies of diabetes concealment and self-fashioning, 
setting standards of use and design that differ from that of the syringe, and that 
model ways of embodying class, racial, gender, and employment differences 
under conditions of social and medical surveillance. Promotional and diabetes 
education materials model insulin pens and pumps as social technologies of 
concealment and beauty that are meant to assist diabetics in their management 
of the public performance of diabetes as if type 1 diabetes is a monitored 
performance of chronic illness. By monitored performance, we refer to the ways in 
which those living with managed forms of chronic disease like diabetes are 
subject to systems of surveillance that are enacted by medical personnel, family 
members, peers, and strangers (see Hall, Monahan, and Reeves 2016, 154–55). 
Additionally, we examine how type 1 diabetics respond to the promotion of these 



 
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devices around the aesthetics of communication technologies. Type 1 blog posts 
and meme propagators speak back to the rather incongruous comparison of 
insulin pumps to pagers, particularly in the current moment, and the awkward 
encounters that result from people misrecognizing their pumps as pagers (which 
the authors of this article also encounter). These responses show up in repeated 
iterations of internet memes and blog posts, suggesting that some type 1 
diabetics share common, and often incredulous, reactions to the comparisons of 
pumps with pagers typically found in marketing and diabetes education materials. 
We focus our analysis on one typical meme representation of the insulin pump-
pager comparison. We also draw on our own experiences with these devices as 
type 1 diabetics to demonstrate how norms of discretion morally regulate the 
performance of diabetes around the skeuomorphic relationships between insulin 
delivery devices and communication technologies.  
 
Deliberately marketed around their resemblance to pens or pagers—
skeuomorphs that “materialize the metaphor” of writing instruments and 
telecommunication tools into the devices of insulin delivery—patents and 
diabetes education and marketing materials present type 1 diabetics with 
normative models for how to perform diabetes using insulin pens and pumps, 
especially around norms of discretion in insulin delivery (see Gessler 1998, 230; 
quoted in Morris 2015). They foster what we call skeuomorphic performances of 
type 1 diabetes. Skeuomorphic relationships between insulin delivery devices and 
communication technologies shape understandings of how the technologies can 
be used. They also shape how type 1 diabetics manage the monitored 
performances of type 1 diabetes around social codes of race, class, and gender, as 
we analyze below. Skeuomorphs are design templates based on the look of older 
technologies that shape people’s understanding of new technological devices (see 
Hayles 1999). Jeremy Wade Morris (2015) explains that skeuomorphs “smooth the 
process of adoption” of new technologies through design features that “make 
new technologies feel more familiar” (50). They create what Jonathan Sterne 
(2020) describes as “an analogy of practice for users and a logic of equivalence” 
within the comparative relationships that are drawn between devices (180).  
 
In the design of insulin devices as communication technologies, the skeuomorphic 
relationship does more than familiarize users with the new devices; it models how 
to perform diabetes with medical technologies that look less like medicalized 
artifacts, in turn transforming expectations of what diabetes technology can and 
should look like. As users encounter what is now a set of standard looks for the 
skeuomorphic design of their insulin delivery devices, they are met with a host of 
cultural connotations, expectations, and prescriptions for use that designers, 
marketers, and health educators further communicate. For type 1 diabetics, the 
look and use of these technologies powerfully shape our relationships to ourselves 
as diabetics, to other diabetics, and to non-diabetics. They model type 1 diabetes 
practice—specifically, the enactment of insulin delivery—by transforming the 



 
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artifacts of insulin delivery to look less and less like the syringe. As we deliver 
insulin, we enact a skeuomorphic performance of type 1 diabetes in conditions 
that are, and feel, monitored by others.  
 
Drawing from feminist surveillance studies research in dialogue with performance 
and disability studies, we approach how insulin pens and pumps are modeled and 
marketed around the act of administering insulin in front of others as “monitored 
performances”: ways of performing diabetic subjectivity in the context of being 
monitored in medical and social systems of surveillance (Hall, Monahan, and 
Reeves 2016, 154–55). As other research identifies, norms of discretion powerfully 
structure the ways in which people come to inhabit type 1 diabetes in conditions 
of monitored performance and the relations of power and coercion in which they 
are enacted (see Broom and Whittaker 2004; Archer 2014; Lucherini 2016;). Many 
type 1 diabetics report feeling surveilled and monitored around their diabetes 
treatment. Diabetics, in turn, are encouraged to manage the appearance and 
performance of their type 1 diabetes treatment—notably their blood glucose 
testing and insulin delivery—in response to the familial, peer, and biomedical 
forms of surveillance that keep watch on diabetics and their compliance with 
medical treatment. Diabetics must work through and sometimes against those 
norms as they embody and perform their diabetic selves in relationship to the 
tools and technologies of diabetes management. Unevenly distributed across 
gendered, classed, and raced social positions, these technologies contribute to 
norms of discretion that can perpetuate feelings of shame and stigma felt by 
diabetics and shape an idealized successful subject with diabetes—one who can 
more easily “pass” as non-diabetic and who can reveal their condition at times and 
in ways that are less stigmatized and stigmatizing. Structures of surveillance 
around diabetes and its performance can thereby intensify practices of 
racialization, class discrimination, and other forms of systemic marginalization. 
The design of insulin delivery devices re-articulates and reproduces the experience 
and meaning of what it is to do diabetes as a form of monitored performance in 
these conditions. 
 
The authors of this article have both lived with type 1 diabetes for most of their 
lives: Rentschler since age one and Nothwehr since age five. We have intimate 
experience with publicly performing our diabetes as people who also benefit from 
systems of race and class privilege—as white and middle-class individuals with 
access to private and provincial health insurance coverage—while also occupying 
other less privileged subject positions. We draw on these experiences as crucial 
tools of self-reflection and diffractive analysis—diffractive because our experience 
and expertise as diabetics enable us to tune into the “patterns of difference” that 
are produced through the entanglements of bodies, technologies, medical 
corporations, healthcare systems, and shared standards of diabetes treatment 
(see Barad 2007, 29; see also Murphy 2012). The differences between us also shed 
diffractive light on the ways diabetic difference is produced in relationship to 



 
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diabetes technologies. As such, we are attentive to the ways device design and 
marketing produces diabetic differences and enacts exclusions at the level of type 
1 diabetes experience (see Barad 2007, 30; see also Haraway 1992).  
 
To be clear, we do not claim to represent all type 1 diabetics, nor would we. 
Instead, our experience and expertise offer two situated perspectives on the 
forms of critical awareness that diabetics develop around how the disease itself, 
and its larger social meanings, emerge from our embodied experiences of the 
relationship between device design and public discourses about insulin delivery 
technologies. Drawing on Lora Arduser’s (2017) study of type 1 diabetic agency as 
ways of “living chronic,” we mobilize our experiential and observational 
knowledge of, and close attunement to, the marketing, promotional, and 
educational discourses around the insulin pens and pumps we use, and the ways 
we have witnessed and participated in their transformations over time. Our own 
relationships to the medical technology of the syringe, for instance, differ because 
of the almost thirty-year gap between our diagnoses. Rentschler was diagnosed in 
1973 and used syringes until the year 2000, when she switched to an insulin pump 
for her insulin delivery. She never used insulin pens. Nothwehr was diagnosed in 
2002 and their parents used syringes for roughly two years before switching to 
insulin pens. By 2007, they were using an insulin pump.3 The generational 
differences in how we relate to diabetes technology also defamiliarize some of our 
own diabetes-related experiences and strengthen our analysis of the “living 
system” of diabetes: that interrelationship between the embodied experiences of 
people with diabetes and the network of diabetes technologies in which we live 
(Forlano 2017). Some type 1’s identify as “disabled cyborgs” as they maneuver 
through their relationships with technologies (see Forlano 2017). Some of us 
diagnosed very early in our lives might not experience diabetes as disabling in the 
same ways, particularly if we have avoided some of the disabling conditions many 
diabetics do, eventually, face. For some of us, diabetes may be experienced 
primarily as chronic, lifelong entanglements of bodies, systems, and technologies. 
Type 1 diabetes, therefore, is experienced and produced at the intersections of 
disabled and chronically diseased lives and the different ways we live and 
experience them.4   
  

“Look Again”: Selling a “Pen-Like” Insulin Delivery Device 
  

The insulin pen made diabetes sort of sexy.  
—Diabetes.co.uk, “Insulin Pens,” YouTube video 

  
When insulin pens were introduced to the consumer market in the mid-1980s, 
marketing materials described the device’s resemblance to a writing instrument, 
making clear the skeuomorphic relationship between the technologies (see Figure 
1). A marketing booklet for the 1986 NovoPen® system insulin delivery device—



 
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one of the very first insulin pens on the market—made the resemblance explicit: 
“It looks like an elegant fountain pen but look again: It’s a really unique 
development in diabetes care” (Squibb-Novo, Inc. 1986; see Figure 2). A 
photograph shows the insulin pen resting on a leather-bound daily planner next to 
a leather briefcase and some sheets of dot matrix computer printer paper. An ink 
pen tucked into the binding of the daily planner highlights the skeuomorphic 
relationship between writing pens and the insulin delivery device. Readers see 
how the “material metaphor” of the ink pen has been designed into the artifact of 
the insulin delivery device and away from the look of an insulin syringe (Gessler 
1998, 230; quoted in Morris 2015). Other sections of the NovoPen® booklet 
visualize the injector’s pen-like look in different contexts: in one, an insulin pen 
appears alongside carpentry tools, while another geared towards children with 
type 1 diabetes shows the device lying amidst color crayons and wooden pencils 
(Squibb-Novo, Inc. 1986a). The insulin pen’s appearance de-medicalized the look 
of an insulin delivery device, tying its design to writing technologies typically used 
in workplaces and classrooms. As Susan Leigh Star (2010) reminds us, boundary 
objects like the insulin pen materialize work arrangements between different 
actors, actors who, in promotional materials, often represent idealized 
configurations of both users and uses of the technology.  
 

 

Figure 1.  NovoPen® insulin delivery pen made by Squibb-Novo Inc., ca. 1986. Division of Medicine 
and Science, National Museum of American History, Smithsonian Institution, Washington, DC. 
Catalog number: NMAH-AHB2012q06840. Permission granted for use. 

 



 
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Figure 2. The 1986 NovoPen® booklet State-of-the-Art Diabetes Care. Division of Medicine and 
Science, National Museum of American History, Smithsonian Institution, Washington, DC. Catalog 
number: NMAH-AHB2012q06897. Permission granted for use. 

 
The NovoPen® system’s marketing materials communicate norms of 
concealment and discretion in the use of an insulin pen, suggesting that there 
might be something socially stigmatizing about taking insulin via syringe and 
being a person with diabetes. Around the object status of the syringe, when 
diabetics use a syringe to administer a dose of insulin, the visibility of this routine 
procedure can carry a sense of shame produced in part by discourses of health, 
able-bodiedness, and “diabetic control” as a moral obligation by which some 
diabetics report being governed (see Broom and Whittaker 2004). The ad copy in 
Figures 2 and 3 directly connects the ease and convenience of using the injector 
with the ability to perform injection discreetly. Jørn Rex, one of the people who 
filed the original patent application for the NovoPen® in 1984, identified 
discretion as an advantage of insulin pen use, “helping to render insulin therapy 
more socially acceptable” (Rex and Vogeley 1986). As he and his co-authors later 
explained, discretion is “particularly important to younger patients who may be 
especially sensitive to peer group approval and the embarrassment and stigma 
surrounding parenteral drug administration. Several students suggest that 
patients feel less conspicuous carrying a NovoPen® device and more comfortable 
using it in public compared with a syringe” (Rex, Jensen, and Lawton 2006, 398). 



 
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As tools of discretion, insulin pens were designed to enable type 1 diabetics to 
manage how their insulin delivery appears to others, and as disability scholars 
argue, “appearance is one of the main modalities by which disability is 
constructed” (Love 2015, 174; see also Goffman 1963; Davis 1995; Garland-
Thomson 1997).  
 

 

Figure 3. The 1986 NovoPen® booklet chapter “Convenient, Discreet, Accurate” in State-of-the Art 
Diabetes Care. Division of Medicine and Science, National Museum of American History, 
Smithsonian Institution, Washington, DC. Catalog number: NMAH-AHB2012q06898. Permission 
granted for use. 

 
Navigating the potentially stigmatizing appearance of non-conformity, disability, 
and disease around insulin delivery, the insulin pen provided a different look to 
the work of doing type 1 diabetes. The insulin pen was specifically designed to not 
look like a syringe, even if it performs the same basic function. NovoPen® 
marketing materials explained the inner workings of the pen by detailing its 
syringe-like parts, representing how the pen worked like a syringe with its needle, 
needle caps, plunger, and barrel but, at the same time, looked nothing like one 
(see Figure 3). While the syringe largely remains the primary iconography of 
diabetes, it has an even stronger association with IV drug use. Insulin pen designs 
interrupt this association around classed iterations of non-syringe-based diabetes 
treatment technology. In the context of monitored public performances, the 



 
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visible “prosthetic object of the syringe,” as Nicole Vitellone (2003) argues in her 
analysis of IV drug users, orients the figure of the syringe-user around the “object 
world of the syringe,” such that the syringe carries the stigma associated with the 
act of injecting illicit drugs (42, 43, 46). Importantly, as Sara Ahmed (2010) 
explains, because affects circulate between objects in relational affective 
economies, emotions like shame can “[sustain or preserve] the connection 
between ideas, values, and objects” (230). As such, the moralizing rhetoric that 
demonizes IV drug use and the IV drug user operates as a vehicle of shame that, to 
some extent, becomes transferable to the diabetic syringe-user via the 
iconography and use of the syringe itself (see Lucherini 2016). Reinforcing this 
association, symptoms of diabetic hypoglycemia —low blood sugar—often look 
and sound like intoxication: slurred speech, incoherence, profuse sweating, 
confusion, and loss of consciousness. Racial and classed stereotypes of drug use 
further complicate these expressions of diabetic hypoglycemia for some diabetics. 
The object status of the syringe is therefore disproportionately “sticky” with 
negative affect that is shared between subjects associated with its use: IV drug 
users and type 1 diabetics.  
 
As such, it is not unusual for type 1 diabetics to sometimes be mistaken as IV drug 
users due to the shared object world of the syringe, reproducing some of the 
shame of recreational drug use in the markedly different context of insulin 
delivery. Rentschler has experienced this common misunderstanding on several 
occasions, including an incident as a teenager in which her boyfriend’s father 
found one of her insulin syringes in the wastebasket, its needle broken off to avoid 
causing harm to those doing waste disposal. Because of the syringe’s powerful 
association with IV drug use, the man assumed she was injecting illicit drugs (this 
was also at the height of the US drug war in the 1980s). To clear up the 
misunderstanding, Rentschler had to explain that she was a diabetic who used 
syringes to inject insulin. Interactions like these are also documented in Mark 
Lucherini’s (2016) study of the performative aspects of diabetes treatment, where 
interview subjects describe the embarrassment that accompanies being mistaken 
for an IV drug user and the efforts they take to avoid such misunderstandings 
(266; see also Browne et al. 2014). While for the author this was merely an 
uncomfortable conversation, these interactions can have more serious 
consequences for racialized and less affluent diabetics who are more subject to 
being stereotyped and criminalized around perceived drug use.  
 
Of course, despite its non-medical uses, the syringe is first and foremost an 
instrument used in the treatment of injury and disease. These conditions carry 
their own stigma, related to the highly personal yet often visible negotiation of 
bodily health and autonomy. As a disease whose management requires a series of 
lifestyle changes and adjustments, diabetics often feel and are stigmatized based 
on how others monitor and judge their behaviors vis-à-vis their personal medical 
care. How that management becomes visible to others becomes a site of 



 
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potential stigmatization, and, as one study stated, “Stigmatization is part of the 
social experience of living with T1DM for adults” (Browne et al. 2014, 1). In a 
recent survey of 12,000 diabetics, 76 percent of type 1’s report being stigmatized 
by others, while 52 percent of type 2’s report being stigmatized (Liu et al. 2017). 
As such, preferring to keep their condition private, some diabetics hesitate to 
disclose their disease to others (Pihlaskari et al. 2020). Studies also show that type 
1 diabetics experience “diabetes distress” due to self-consciousness and social 
stigma, as well as the burdens of having to daily manage a serious chronic disease 
(Balfe et al. 2013). These findings echo Susan Wendell’s ([2001] 2017) explanation 
that “people with chronic illnesses are likely to be blamed or held responsible not 
only during the process of seeking a diagnosis, but also during every relapse or 
deterioration of their condition, which they are expected (by doctors, loved ones, 
employers, and the general public) to control” (170). Any “fluctuations in our 
illnesses and abilities…contribute to the perception that we are responsible” and 
that “we are doing something wrong” (Wendell [2001] 2017, 170). In the context of 
type 1 diabetes, “any failure in self-management may become bound to a sense of 
shame, producing a diabetes-shame-bind that is activated whenever criticized” 
(Archer 2014, 104). A failure to care for one’s diabetes, as some diabetics report, is 
often interpreted by others as a moral failure (Broom and Whittaker 2004, 23; see 
also Mol 2009). 
 
Because of these complex negotiations with feelings of shame and experiences of 
social stigma, type 1 diabetes management has long been structured by concerns 
with discretion and privacy, as something to be “moralized for the benefit of those 
without diabetes” (Hall, Monahan, and Reeves 2016, 164). For type 1 diabetics in 
particular, “the shift toward constant and concealed treatment practices is 
emblematic of a much broader system of biomedicalized control that devalues 
non-normative bodies, and thereby devalues a life lived with(in) one” (Horrocks 
2019, 3). Lucherini’s (2016) research found that “people with diabetes often 
express a sense of felt surveillance of their bodies when in public space” such that 
“being seen doing self-management could instill a sense of shame” (261, 271). He 
describes the labor type 1 diabetics do to “manage their self-management” of the 
disease in front of others (Lucherini 2016, 261), work that is moral and emotional, 
as well as physical and technological (Horrocks 2019). With technologies designed 
for discretion, like insulin pens, “the relative ease of concealing many of the 
management practices of diabetes” also “means that people can pass” as non-
diabetic (Lucherini 2016, 269), shaping a form of moral labor involved in doing 
diabetes with technology. 
 
Marketing brochures demonstrate how the insulin pen was designed for purposes 
of concealment as well as insulin delivery. Modeling the insulin delivery device as 
a pen familiarized the medical technology through its shared design features, in 
ways that could help diabetics manage how others might see and understand it.  



 
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The booklet for marketing the 1986 NovoPen® line emphasized the discretion 
that a pen-like medical device could provide as something users could wear as an 
accessory (see Squibb-Novo, Inc. 1986b). The clip on the exterior of the insulin 
pen (see Figure 1), for instance, suggested how the device could be worn in the 
breast pocket of a work shirt or blazer like a similarly designed ink pen, turning it 
into an accessory that could fit workday modes of comportment. The 1984 patent 
application for the device also described that the clip enabled users to wear it on a 
pocket, materializing preferred forms of user embodiment that were part of the 
legal case-making for the designer’s property claims (see Rex and Vogeley 1986, 
7). Each of the pen’s design features follow a general principle similar to that of 
medical design for disability: “to compensate for disability as discreetly as 
possible” (Pullin 2009, 4). 
 
Marketing materials and user booklets modeled the process through which one 
would use the pen to deliver insulin. In the NovoPen® brochure, photos show 
people using the device to deliver insulin across a variety of contexts during 
monitored performances of diabetes management. One image depicts a Black 
woman dressed in professional attire injecting insulin into her thigh as she sits at a 
desk (see Figure 2 above), communicating the image of a successful diabetic 
subject, someone who can manage a high-powered career and also fit the 
stereotypical image of health. Such images of control are often projected onto 
people with office or white-collar jobs, and who more readily appear as healthy 
and “normate bodies” (Garland-Thomson 1997, 8). In marketing photographs, the 
insulin pen appears to function as a social equalizer, providing discreet medical 
solutions to everyone. The Black woman is the only person of color shown using 
the device in the set of NovoPen® materials we reviewed from the Smithsonian 
Institution archive. She embodies norms of Black middle-class respectability that 
are portrayed alongside White-identified normate diabetic subjects of different 
ages and genders, including an elderly white woman and a male construction 
worker, firmly designating “healthy” bodily comportment through the 
performance of class, gender, and racial norms of middle-class professionalism, 
white working-class masculinity, and domestic white womanhood (see also 
Squibb-Novo, Inc. 1986b). All appear as successful diabetics who treat their 
condition in view of others without moral or social sanction.  
 
The NovoPen® was designed to look like not just any pen but a beautiful pen that 
could signal the status value of the object, thus also communicating, potentially, 
the user’s seemingly affluent or class aspirational status. The 1986 booklet for the 
device describes the design in detail: “The handsome nickel and chromium-plated 
brass construction provides durability along with the sleek fountain-pen look” 
(Squibb-Novo, Inc. 1986b). The emphasis on desirable aesthetics is also seen in 
more contemporary designs as well, of which online reviews make particular note. 
In 2020, a review details key aesthetic features of current pens on the market, 
describing a HumaPen brand pen as “extremely handsome,” especially “for those 



 
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who are uncomfortable with the idea of pulling out syringes at work or during 
business conferences.” Another HumaPen is described as “an expensive writing 
instrument,” echoing insulin pen designs from the 1980s that could appear like 
professional objects (Tzemis 2020). The skeuomorphic design—and 
performance—of insulin pens to look like fancy writing instruments still holds 
today. For children and adolescents, pen designs use bright colors and fun decals. 
As a child in the early 2000s, Nothwehr used a NovoPen® Junior pen, which was 
marketed through its brightly colored patterns. New “smart” insulin pens also 
look like colorful and fashionable ink pens that are sold in specialty stationery 
stores. 
 
The insulin pen thus fashions discretion around the sleekness, desirability, and 
appealing aesthetics of the technology in ways that recode the meaning and look 
of diabetes concealment and disclosure. Further emphasizing its aesthetic value, 
the insulin pen is not miniaturized to be hidden like a hearing aid nor flesh-colored 
like a prosthetic limb, common strategies for designing for discretion in disability 
(Pullin 2009). Instead, its design illustrates that “discretion does not require 
invisibility” (Pullin 2009, 15), but may instead demand a desirable aesthetic object, 
or what disability design researcher Sara Hendren (2020) calls “charismatic 
things”: devices that “not only work” but also have “elegant presence or pleasure 
in its handling, some kind of draw, a thing that pulls you in or makes you think 
while also being handy, modest, even garden-variety in its value” (8). 
 
Using the pen to inject insulin in full view of others suggests that type 1 diabetes 
management can be done discreetly within the context of day-to-day activities, 
without violating expectations of normative public behavior, at least for some. 
Some marketing images transform public scenes of what might be viewed as 
humiliating into something that appears ordinary. In a photo used to market the 
1986 NovoPen® device, a child sits in a chair injecting insulin into their thigh, 
pants down and underwear visible (see Figure 3). In many contexts, this image 
would represent a scene of humiliation, but instead the child appears in full view 
of their teacher and classmates, as if giving an injection of insulin might be 
analogous to other expected classroom behaviors. This image also communicates 
the supposed ability of the NovoPen® to shield children from shame related to 
syringes and appearing diseased. Such a negation of shame may be partly 
dependent on the child’s otherwise normative subject position—as white, 
seemingly middle-class, and attending school. As Lennard Davis (1995) argues, 
such performances of “normalcy must be constantly enforced in public 
venues,…must always be creating and bolstering its image by processing, 
comparing, constructing, deconstructing images of the normal and the abnormal” 
(44). Across these marketing materials, images of successful diabetic subjects 
embody age-based, classed, raced, and gendered standards of morality expected 
of public diabetic bodies that appear otherwise normate. 
 



 
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The pen also models the type 1 enactment of disclosure, of “coming out” as an 
insulin-dependent diabetic, a condition disclosed through the use of diabetes 
technologies. As Ellen Samuels (2003) argues, “Narratives of people with ‘hidden 
impairments,’ like those of people with other nonvisible social identities, are 
suffused with themes of coming out, passing, and the imperatives of identity” 
(237). Samuels unpacks the analogies commonly drawn between coming out as 
disabled and coming out as an LGBTQ individual, two identities she herself shares 
as a lesbian disabled person, in order to assess how they are used in the process of 
revealing non-visible disability. For Samuels (2003), coming out as disabled is 
“primarily portrayed as the process of revealing or explaining one’s disability to 
others rather than as an act of self-acceptance facilitated by a disability 
community” (239). While there are a range of practices and meanings people give 
to the disclosure of non-visible impairments and chronic conditions, the practice 
of disclosure usually “connotes the daily challenge of negotiating assumptions 
about bodily appearance and function” by others (Samuels 2003, 239). As a queer 
person, Nothwehr has found that revealing their diabetes carries a different sense 
of shame than coming out as queer, although the emotional toll of disclosure is 
still considerable. For them, the shame of coming out as diabetic is strongly linked 
to fears of being pitied as someone living with chronic illness, whereas coming out 
as queer more often generates trepidation in relation to homophobic comments 
or outside expectations of their gender presentation or sexuality. The shame 
related to both forms of disclosure emerges in how others view, react to, and label 
them as the disclosing subject. Because diabetes is not typically visible in the 
same ways that sexuality often is, diabetics must negotiate normative 
assumptions of able-bodiedness by either divulging their stigmatized condition or 
working to appear, or “pass,” as normate as possible. In this context, the ability to 
pass as non-disabled, or as not having diabetes, may not communicate a desire to 
assimilate, but could instead signal resistance to norms of surveillance applied to 
non-normate bodies in order to avoid “the denial, mockery, and silent 
disapproval…used to inhibit us” (Samuels 2003, 242). 
 
Type 1 diabetics use a range of disclosure strategies to inform others about their 
disease, from more performative models of revelation via the public use of 
diabetes technologies to other modes of disclosure where they introduce others 
to the disease and how it is managed. In Rosemary Garland-Thomson’s (1997) 
words, the successful diabetic subject who may casually use their medical 
technologies to disclose their condition is an example of “the constructed identity 
of those who, by way of the bodily configurations and cultural capital they 
assume, can step into a position of authority and wield the power it grants them” 
(8) based on the race, class, and gender privileges they have. These diabetic 
subjects are defined by virtue of not being those who appear as “marked bodies 
[which] shore up the normate’s boundaries” (Garland-Thomson 1997, 8). 
 



 
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While the NovoPen® brochure highlighted the ability to conceal the device’s 
medical use and thus pass as non-diabetic, it also illustrated the contexts in which 
users could unveil what the device is designed to do, suggesting how users can 
exert some control over the moment in which they disclose their diabetes to 
others at the point of insulin delivery. In this way, the brochures trained insulin 
pen users in how to both conceal their insulin delivery devices and reveal their use 
for medical treatment through visible “scripts of use” (Akrich 1992, 208). Doing 
the work of “de-scription,” brochures modeled the “mechanisms of adjustment” 
users can engage in order to reveal their status as type 1 diabetics using an insulin 
pen (Akrich 1992, 209). 
  

“What Year Is It?”: The Insulin Pump-as-Pager 
Insulin pumps—what inventor Dean Kamen called an “automatic syringe” after his 
1973 design patent application for the device—are another technology through 
which type 1 diabetics infuse insulin into their bodies.5 Early insulin pump models 
took the use, purpose, and design of the syringe as a conceptual model and point 
of departure, envisioning the insulin pump as automating syringe-based insulin 
delivery. The AutoSyringe included a plastic syringe on the outside of the device 
paired with a motorized plunger that operated to deliver incremental doses of 
insulin at specified times. Kamen’s design functioned as a mechanized method of 
using syringe technologies, with the device operating as a chassis that surrounded 
a syringe and automated its use. In fact, the external syringe was not concealed in 
any manner by the material design of the early insulin pump and was easily 
recognizable as a medical device, if not a somewhat unusual looking one at that 
(see Figure 4).6 

 
More recent pumps have been designed to resemble communication technologies 
in a related move away from the aesthetics and look of the syringe. Over time, the 
pump has been continually redesigned to conceal its function as an automatic 
insulin delivery device, eliminating almost all easily recognizable design elements 
of the syringe. Making no mention of syringes or needles, medical brochures and 
online diabetes education sites from the 1990s and early 2000s instead routinely 
make comparisons between insulin pumps, pagers, and cellphones, around their 
shared technological resemblance (see, e.g.,Novo Nordisk Pharmaceuticals, Inc.  
2002). An image included in a medical journal article on insulin pump therapy 
from the early 2000s illustrates the comparison (see Figure 5). At the bottom of 
the photo, a black MiniMed 508 pump sits next to a black Motorola brand 
PageNet pager circa 2001, highlighting their similarities in shape, screen 
appearance, and button design. Two other insulin pumps appear at the top right 
of the image next to a silver Samsung flip mobile phone—the D-Tron pump, 
discontinued in 2003 (Disetronic Medical Systems 2003), and the H-Tron Plus 
pump, first approved for use in the United States for insulin delivery in 1991. The 



 
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visual juxtapositions draw a direct association between these insulin pumps and 
the design of iconic telecommunication technologies of the time. 
 

 

Figure 4. The AutoSyringe device for delivering insulin, shown here worn by AP photographer 
Patrick Connolly sometime between 1978 and 1984 (see Hurley 2014; Connolly 1986). The original 
caption to the image reads, “Associated Press reporter Patrick Connolly, in Seattle, Wa., Dec. 18, 
1986, adjusts the insulin pump he wears on his belt to keep his blood sugar near normal. Connolly, 
who has had diabetes for 27 years, receives a squirt of insulin through a slim tube into a small 
needle under the skin of his abdomen every few minutes from the one-pound pump. For Connolly 
the experimental device is more effective than 10,000 insulin shots he has had. (AP Photo).” The 
date listed in the caption is inaccurate, however, because Connolly died in 1984 (see Connolly 
1986). Permission granted by the Associated Press under license LIC-01416244. 

 



 
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Figure 5. The caption to the image reads, “The insulin pump is comparable in size to a cellphone or 
beeper. The cellphone in the upper left is similar to the Disetronic pump on the upper right. In the 
lower right corner, the MiniMed pump is comparable to that of a beeper on the left” (Jayarag, 
Davis, and McNeill 2001, 139). 

 
Compared to the insulin pen, the insulin pump moves even further from the 
stigma of the syringe, towards the look—and haptics—of less morally fraught 
communication technologies. The look of the insulin pump distances it from both 
the visual appearance of the syringe and its methods of use, which, notably, the 
insulin pen does not conceal. The insulin pen still relies on the basic design 
concept of a syringe; it has a plunger, barrel, hub, and needle, which function in 
the same manner that a medical syringe would. The pen also necessitates a more 
public, and clearly medical, demonstration of its use as users must wash their 
hands, clean their injection site with rubbing alcohol, manipulate their clothing, 
and visibly inject insulin into their bodies using a needle. To administer a dose of 
insulin with an insulin pump, one must use the pump’s buttons or touch screen to 
input biometric information into the device, which is then used by the pump to 
calculate and deliver a dose of insulin through an infusion set attached to the 
body. Adhering to the skin, the set includes a flexible cannula to transmit insulin 
subcutaneously. As Laura Forlano (2016) explains, “as an information technology, 
the pump more easily fits into social situations than needles” and can go virtually 



 
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unnoticed as a medical device. With almost no visual cues of the pump’s medical 
nature either through its appearance or use, in the early 2000s, Rentschler 
encountered students who thought that the clear tubing attaching her insulin 
pump to her body was an electrical wire connected to a battery pack in her pants, 
powering the “pager” she wore on her belt. At the time, pagers were still in 
regular use. The pump’s resemblance to a pager also picked up on popular cultural 
connotations of the telecommunication device as something used by busy 
professionals, similar to the insulin pen’s resemblance to a fancy fountain pen. 
 
The misrecognition of the pump as a pager is not so much a failure to be properly 
oriented to the device but is instead a kind of success: the early description of the 
pump as pager-like still works, even as pagers have become outdated 
technologies. This is seen in how closely linked the look of the pump as pager-like 
is to how diabetics interact with and carry the device. Insulin pumps are, for some 
users, understood as technologies one wears, as if an accessory or fashion item; 
they are frequently clipped to people’s belts and pants, as a pager would be. 
Diabetes education websites emphasize the pump as a tool or accessory of self-
fashioning, stating, for example, “Most pumps are ‘worn’ on a belt, carried in a 
pocket, or attached by a holster and connected by thin plastic tubing to the 
infusion set” (Diabetes Education Online, n.d.).7 Describing pumps as something 
one wears, like prescription eyeglasses, “provides a shift in perspective from a 
medical model to a social model of prescription” (Pullin 2009, 19, emphasis in 
original). As Pullin explains, when prescription eyeglasses became “eyewear,” 
they were perceived as fashionable items of clothing rather than medical devices. 
This suggests that diabetics form orientations to these devices based on how they 
physically carry or port the technology. 
 
Advertisements and marketing material in the 1990s emphasized the 
skeuomorphic design of the pump-as-pager, highlighting its look as one of the 
draws of insulin pump therapy. At the time, manufacturers strove to reassure 
pump users that their insulin delivery device would be unrecognizable to others as 
a medical technology and would allow them greater freedom in their everyday 
life. Including testimonials from diabetic users, many advertisements stress the 
ability of pumps to be concealed as medical technologies that enable patients to 
lead “normal” lives, paradoxically linking concealment to the subject’s sense of 
freedom and agency. Today’s marketing of insulin pumps continues to emphasize 
diabetic freedom from social constraint. Recent advertisements show the pump 
being used in a variety of non-professional settings, such as classrooms and soccer 
fields. According to an online patient brochure for the recent Medtronic MiniMed 
670G pump, syringe injections are “a distraction that...interfere with the normal 
rhythm of [patients’] lives” (Medtronic 2017, 2). Nicky, a high school student, 
credits the pump with helping her enjoy family meals “without having to excuse 
herself to inject insulin,” while John, a family man and business professional, is 
shown on a business trip, able to juggle meetings and conference calls because 



 
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the MiniMed 670G pump is “on the job too” (4). In this context, normalcy alludes 
to ways of performing diabetes that are easily folded back into normative ideals of 
a meaningful and successful life: family time unencumbered by the stress of 
chronic illness and a professional career driven by capitalist modes of productivity 
and fulfillment. With the pump, users appear as self-fashioned subjects who are 
no longer defined by their relationship to the device—as students and athletes—
and convey very specific forms of subjectivity formulated around ideals of 
youthful and active embodiment. Because these technologies blend into the 
background, both to the user and to others, the diabetic subject can move 
through life “like anyone else,” enacting norms of discretion with the pump that 
offer visions of ease in social and familial situations.  
 
Although a 2018 study found that approximately 30 to 40 percent of type 1 
diabetics in the US use insulin pumps, these numbers are likely higher now due to 
the increased availability of pump technologies (Umpierrez and Klonoff 2018). 
Increasing usage does not necessarily mean that the technology is more 
economically accessible, however. As of 2015, an insulin pump cost about 
US$6,000 and supplies for the pump cost $3,000 to $6,000 annually, a staggering 
amount for the vast majority of diabetics, even for those with health insurance 
coverage that pays a portion of the costs (McAdams and Rivzi 2016). As of 2015 in 
Canada, all provincial health systems provide coverage for insulin pumps and their 
supplies for children up to age eighteen and some up to age twenty-five; only one 
province, Alberta, provides coverage for adults after the age of twenty-five 
(Diabetes Care Community 2015). Many adult Canadian pump users do not have 
private insurance to cover the costs of pumps and their supplies, and cannot 
afford the costs on their own, forcing some to have to abandon pump therapy for 
injections (see Bergen 2019). The sheer cost of insulin pump technologies and 
their supplies carries clear financial and class implications. Diabetics who are able 
to afford the pump and its related costs have, in turn, more access to preferred 
treatment regimens than those who cannot. It may also be more difficult for 
diabetics who cannot afford the pump to conceal their condition in public, thus 
situating those without access to the necessary resources to be viewed, 
potentially, as less successful diabetics under conditions of monitored 
performance. 
 
Even though insulin pumps are expensive, they do not necessarily look like 
sophisticated modern technologies. Many still look like the outmoded pagers of 
their earlier skeuomorphic design and are still described as such to consumers. A 
University of California-San Francisco diabetes education site explains to potential 
users that “insulin pumps are the size of a pager, and fit in your pocket” (Diabetes 
Education Online, n.d.; see also Diabète Québec 2020, Canadian Diabetes 
Association 2013). Diabetes Forecast, the monthly US magazine about diabetes 
published by the American Diabetes Association, explained the look of the device 
with a potential witness in mind: “If you've ever seen a person with diabetes 



 
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wearing a pager-size gadget on his or her hip, you've probably seen an insulin 
pump” (Diabetes Forecast 2009). Describing the pump through the eyes of another 
subject suggests that the skeuomorphic design of the pump-as-pager is as much 
for the non-diabetic viewer as it is for the diabetic user, if not more so. The 
skeuomorphic relationship between the pager and the pump, then, persists, doing 
a form of cultural work that is meant to familiarize users and non-users alike to 
the insulin pump around their technological resemblance.  
 
Today, pagers are largely understood as vintage technologies; many are sold on 
eBay as theatrical props rather than functioning text messaging machines. The 
pager-like look of the pump could itself be understood as a theatrical prop used to 
conceal its use to non-diabetics in the performance of type 1 diabetes care. To 
echo Raymond Williams (1977), the pager may have been “formed in the past, but 
it is still active in the cultural process…of the present” (122). The strange “residue” 
of the pump/pager relationship might “guide us to this presence of the past” in the 
ways some insulin infusion pumps continue to be designed and marketed around 
the look of this older technology (Acland 2007, xxi). 
 
In light of the strange persistence of this design, insulin pump users have 
developed a range of vernacular responses to being asked about their pumps in 
disguise as pagers. Some diabetics respond with humor, critiquing the pager as a 
technology cast out-of-time (see Figure 6). Memes about the misrecognition of 
insulin pumps as pagers populate type 1 diabetes meme sites, giving popular 
cultural form to a kind of response insulin pump wearers might use to disrupt the 
misrecognition of their device as a pager. We draw attention to one common 
meme that appears online in Figure 6. The meme uses an image macro of actor 
Robin Williams in a scene from the film Jumanji (1995), when his character, Alan, 
asks two bemused children and a suspicious police officer “What year is it?” after 
he has escaped from a board game in which he’d been trapped for twenty-six 
years (“What Someone Is Probably Thinking” 2018). Commenting on the obsolete 
or out-of-sync phenomenon of the pager/pump comparison, the meme conveys 
the confusion that accompanies the device’s incongruous appearance and 
anachronistic design. After all, to a non-diabetic person, the pump resembles a 
pager but is temporally and contextually displaced from its more prevalent use in 
the 1990s, leading to the assumption that the pump is not quite a pager but is also 
not a technology that is immediately recognizable. 
 



 
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Figure 6. “What Year Is It?” Robin Williams meme on pagers as obsolete technologies in 
comparisons to insulin pumps (“What Someone Is Probably Thinking” 2018).  

 
The question then becomes, what is it really? As Sara Ahmed (2007) suggests in 
Queer Phenomenology, for technologies, “the object itself has been shaped for 
something, which means it takes the shape of what it is for” (46, emphasis in 
original). Through its skeuomorphic design, the insulin pump communicates that 
the device is something that it is not: a pager. The look of the pump-as-pager 
suggests that the pump is in some sense not only meant to appear as a 
communication device, but that it is a communication device, transmitting insulin 
from a pump reservoir into the body but also communicating norms of diabetic 
comportment based on concealment. Their designs as communication 
technologies, as we have been arguing, also evidence how they communicate 
social norms about diabetes comportment that enable diabetics to “manage the 
self-management” of their disease in view of others (Lucherini 2016, 261). 
  
Some patent applications make the connection between insulin pumps and 
communication technologies even more explicit. A patent filed in 2012 by Bigfoot 
Biomedical, Inc. for an insulin pump media player takes the pump-as-
communication-technology one step further by designing mobile music playback 
capabilities into the pump, replete with a hard drive and headphone jack. A 
diagram included with the patent application shows a pump user listening to the 
band Van Halen’s 1988 song “Cabo Wabo” via the insulin delivery device, 
revealing something of the designers’ taste culture and their imagination of who 
their users might be: fans of the band Van Halen (see Figure 7). While the pump’s 
material design still resembles a pager, the capabilities of this pump suggest an 



 
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additional use as an MP3 player. Note how the user is pictured in the diagram with 
their headphones plugged into the insulin pump. According to the patent 
application, “in particular embodiments, the portable infusion pump system can 
serve a dual purpose of providing medication and entertainment for the user from 
a compact and unobtrusive device” (Wenger, Estes, and Chiang 2016), combining 
the aesthetics of discretion with a new articulation of the pump as a media player. 
While to our knowledge an insulin pump media player has never been brought to 
market, the patent application reveals how pumps are expected to be understood 
as communication technologies.8 The design for the insulin pump-media player 
takes this association to its logical conclusion. The idea of the pump as a wearable 
communication technology that is also associated with media players appears as 
well in marketing images of headphone-wearing pumpers, as if there is an 
embodied relationship between insulin pumps and media players, even when they 
are not combined into the same device (see Figure 8).   
   

 

Figure 7. The insulin pump-media player diagram in a US patent application for the device 
(Wenger, Estes, and Chiang 2016).  

 



 
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Figure 8. John, a Medtronic 670G pumper, wearing headphones. Screenshot from Medtronic 
marketing packet on the 670G pump model (Medtronic 2017). 

 
In response to this, some pump designers and manufacturers have recently begun 
to update pump designs, like that of the Tandem t:slim X2, which both authors of 
this article use, to resemble sleek smartphones with slimmer profiles, full-color 
touch screens, button-based wake up and shut-off features, and silver accents 
(see Figures 9 and 10). Compared to the pump-as-pager design, this new 
skeuomorphic relationship is arguably more successful in articulating the 
appearance of the insulin pump to that of an aesthetically desirable 
communication technology in the present moment. In its online marketing, the 
current Tandem pump is often pictured from the front, with its full-colour screen 
illuminated in ways that make it appear like something akin to a smartphone 
screen. Sometimes the pump is pictured alongside a smartphone to demonstrate 
how the pump communicates with a continuous glucose monitor that sends data 
to a mobile phone app. But it also communicates how closely the pump also looks 
like a small smartphone (see Tandem Diabetes Care, Inc. 2020).  While these new 
pumps appear like smartphones, they act quite differently. For Forlano, the 



 
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smartphone-like pump does not so much recede out of perception but instead 
beeps, alarms, and requires attention from its user as a needy and rather obtrusive 
device. “Their sounds diverge from the familiar family of Apple iPhone ringtones. 
They speak in tongues. The uninvited stranger at the dinner party” (Forlano 2016). 
The promise that the pump will recede from view and blend in to one’s outfit 
through its design as a contemporary communication technology, then, may 
shape a visual relationship between diabetics and non-diabetics more than the 
embodied, sonic relationships diabetics have with their insulin pumps. Diabetics 
can also easily recognize each other's pump technologies and the unique sonic 
alarms they use, shaping our relationships to insulin delivery devices in ways that 
complicate their abilities to hide diabetes. Hearing the sonic alarm of one of our 
pumps, the authors of this article have on more than one occasion asked the 
other, is that you or me?   
  

 

Figure 9. Side view of Tandem t:slim X2 pump (on the right) and an iPhone 8 (on the left). Note the 
similarity of the on/off buttons and the comparable thinness and shape of the two devices. 
Photograph by Carrie Rentschler. 

 



 
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Figure 10. Screen view of Tandem t:slim X2 pump (on the right) and an iPhone 8 (on the left). Note 
the similarities of the device shape, touch screens, and protective glass screen shields, and the 
shared look of the black cases. Photograph by Carrie Rentschler. 

  

Conclusion: Skeuomorphic Relationships as Scripts of 
Morality 
By using medical devices designed not to look like syringes, type 1 diabetics 
manage the relationships between self and other as skeuomorphic performances 
of doing diabetes with technology. The insulin pen and insulin pump provide a 
kind of “cover” for type 1 diabetics, a way of wearing medical technologies that 
look like fashionable and ubiquitous communication technologies, even ones that 
are, for all practical purposes, obsolete, like the pager. As our analysis has 
demonstrated, administering one’s insulin is a monitored performance of diabetes 
self-management, a moment many diabetics experience as an exposure of one’s 
diabetes to others that is governed by norms of gender, race, and class 
differentiation, and exclusions. Like many other chronic diseases, diabetes 
remains a hidden medical condition until it becomes visible, and legible to others, 
at the moment of its management via medical technologies (Lucherini 2016; see 
also Mol and Law 2004; Hall, Monahan, and Reeves 2016, 163). The design of 
diabetes technologies to help conceal what is already meant to be hidden helps 
diabetics manage those disclosive moments of self-management (Lucherini 2016, 
260), through insulin delivery technologies designed to look less and less like 
syringes and more like pens, pagers, and smartphones.  



 
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As functional technologies, the design of insulin pumps to look, feel, and act like 
communication technologies materializes a broader set of cultural meanings, and 
practices, tied to insulin delivery that also negotiate the distinctions between 
diabetes as a chronic disease and diabetes as a disability (see Balsamo 2011). As 
feminist disability scholars argue, it is in part in the “performative uses of 
technology” through which we “transform the meaning of functional technology 
from rehabilitative or adaptive to cultural” (Hamraie and Fritsch 2019, 18). Our 
analysis of the performative aspects of doing diabetes with skeuomorphic 
technologies contributes to scholarship in feminist disability studies and STS 
research around these skeuomorphic performances and what they reveal about 
type 1 diabetes as a socially differentiated set of experiences, and realities, of 
living a chronic life in relation to medical technologies. As scholars of media and 
communication studies, we are also acutely aware of the significance that the 
design and marketing of insulin delivery devices as writing instruments, pagers, 
and smartphones play in the meanings that medical corporations and diabetes 
education give to these technologies, and the larger social roles they are 
delegated to play in scripts of gendered, raced, and classed diabetes 
performance. These meanings crystallize in the devices themselves and in the 
documentary materials around which they have been designed, described, 
marketed, patented, and trained for use. While these devices transmit insulin, 
they also communicate much more than that: they embody ideals of success and 
failure in chronic disease management; they model fashionability and prescribe 
aesthetic desires and values into the very meaning of what diabetes treatment 
looks and feels like; and they reproduce the structures of class, race, and gender 
inequalities that differentiate the lives of diabetics, making some of us more 
vulnerable to rituals of shame and judgement that get enacted through the 
powers of surveillance. 
 
As type 1 diabetics, we intimately know what it means and feels like to enact 
diabetes care as part of the ways we perform ourselves in everyday life. Because 
we experience our daily lives as monitored performances of chronic disease, we 
have learned how to conceal and reveal our type 1 diabetes as a set of practices 
tied to our use of skeuomorphic insulin delivery technologies and blood glucose 
monitoring, the latter of which we have not analyzed here. By “materializing the 
metaphor” of insulin delivery as a form of communication, insulin pens and pumps 
script norms of discreet and successful type 1 diabetes self-management directly 
into the technologies of insulin delivery and the social rituals we as type 1 
diabetics use to dose insulin into our bodies. Moving further and further from the 
look of the syringe, insulin pens and pumps communicate a different vision of 
diabetic embodiment modeled on the look, style, and materials of familiar 
communication technology, right down to the headphone-wearing pumper 
imagined in the 2012 Bigfoot Biomedical, Inc. patent application for an insulin 
pump-media player device. The camouflaging of insulin delivery is constructed as 



 
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28   

beneficial, even necessary, for diabetics because these technologies shape the 
boundaries of the successful diabetic subject, displacing the stigma of diabetes, 
and of the medical technology of syringes, onto others. They present visions of 
diabetic subjectivity that articulate the use of technologies for concealing 
diabetes with powerful, and often highly moralized and moralizing notions of 
diabetic freedom, liberty, and agency. They suggest not so much that diabetes 
must or should be made invisible, but that it can, and should, be fashioned to look 
like something it is not.  
 
By confronting, negotiating, and rejecting the norms of concealment enacted 
through the skeuomorphic design and performance of diabetic medical 
technologies, diabetics challenge some of the standards of morality that 
condition diabetic subjecthood and embodiment. Further research might take up 
some of these issues to examine how type 1 diabetics develop additional 
strategies and innovate new practices around their performance of the daily 
rituals of diabetes self-management. Additional analysis could reveal some more 
of the nuances in how diabetics model their behavior around the skeuomorphic 
design of their devices to negotiate the embedded standards of morality that 
condition diabetic subjecthood and embodiment, particularly online, where type 1 
blogs and social media sites provide key archives for examining how diabetics talk 
about and speak back to these norms and ideals, and construct new ones in their 
stead. 
 

Acknowledgments 
We’d like to thank the anonymous reviewers for the feedback they provided on 
the manuscript, and the Catalyst editors for their help seeing the manuscript 
through the review and production process. This has been an especially positive 
and constructive publishing experience for us: thank you! We are grateful to four 
other interlocutors and readers who provided essential feedback and advice as we 
developed the manuscript: Gabriella Coleman, Radha Hegde, Margaret Schwartz, 
and Jonathan Sterne. Funding for the research was provided by the McGill 
University William Dawson Scholar fund.     
 

Notes 
1 To refer to people living with diabetes, we use both the person-first terminology 
of a person or people with diabetes and the term diabetics. The International 
Diabetes Federation, the American Diabetes Association, and the American 
Medical Association have all established language standards for referring to 
patients in diabetes care as persons with diabetes. Doing so frames diabetes as a 
condition a person has, rather than a type of person someone is, avoiding the use 
of the disease to describe a person’s identity (see Broom and Whittaker 2004; 
Iverson et al. 2007; International Diabetes Federation 2014; American Diabetes 
Association 2017; Dickinson et al. 2017). Person-first language is less judgmental 



 
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29   

and avoids stigmatizing people living with diabetes, centering the person, rather 
than the disease. We recognize the significance of person-first language, 
especially in the context of the medical clinic, where language can be used to 
judge, stigmatize, berate, and exclude people living with disease. Based in our 
own experiences and the ways we refer to ourselves as both “diabetics” and 
“people living with diabetes,” we use both terms in this article, in recognition of 
the choices people living with diabetes make in terms of how they refer to 
themselves.  
 
2 Other insulin pens were also on the market in 1985, including the “Autopen” 
made by Owen Mumford Limited in the UK, but many—particularly those 
associated with Novo Novodisk—assert that the NovoPen® was “first.” See 
Science Museum Group, “Autopen,” insulin injection pen, UK, 1985, object 
number 1993-932, Science Museum Group Collection Online, accessed October 
22, 2020, 
https://collection.sciencemuseumgroup.org.uk/objects/co143504/autopen-
insulin-injection-pen-united-kingdom-1985-insulin-injecting-device. 
 
3 Rentschler uses she/her pronouns, while Nothwehr uses they/them pronouns. 
 
4 The authors of this article use both the terminology of chronic illness and chronic 
disease to talk about diabetes. Diabetes is not always defined by, or experienced 
as, illness or a state of being sick, but can also be experienced as a medical 
condition one has that requires treatment.   
 
5 Inventor Dean Kamen (1975b) filed a patent application in 1974 for a Medication 
Injection Device that “controlled for repetitive delivery, by intravenous injection or 
otherwise, of predetermined syringe volumes of said medication at present time 
intervals, wherein the syringe plunger medication injection stroke is achieved 
using a powering motor, and the control exercised over the mode of operation of 
the device is related to the rotational traverses of said motor” (1). Prior to his 
application, two other patents were filed for “automatic injectors”: one for a 
“motor driven fluid administration device” in 1965 by W.R. Jewett (US patent # 
3,456,649) and another for “angiographic injection equipment” in 1966 by Marlin 
S. Heilman Gibsonia and Donald Jones (US patent # 3,623,474). Kamen’s 1974 
(1975a) patent application for a “control device for a monitor supervising a 
patient” provided designs for a system that would regulate and monitor the use of 
automatic syringes, enabling their broader use in medical settings (1). In 1976, 
Kamen founded AutoSyringe, Inc. to bring designs for the automatic syringe to 
market. He is credited with designing the first insulin pump (see “Dean Kamen” 
2018). 
 
6 While Wired magazine, where the photo was republished, and the Associated 
Press both identify that Connolly wore the device in 1986, this is not possible, 



 
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30   

because Connolly died in 1984 at the age of forty-one from a heart attack caused 
by his lifelong diabetes, as reported in the New York Times and in a book published 
posthumously after Connolly’s death, titled Love, Dad (see New York Times 1986). 
The image of Connolly wearing the automatic syringe also appears on Pinterest 
and blogs such as Savvy Diabetic, reproducing this error. The automatic syringe 
that is pictured is likely circa 1978. 
 
7 Not all pump users talk about wearing their pump technology. While Rentschler 
refers to wearing her insulin pump, which she clips to a belt or the waistband of 
her pants, Nothwehr more often refers to using or carrying their pump in their 
pants pocket. 
 
8 Motivated in particular by his son Sam’s diabetes needs, Bryan Mazlish describes 
the mission of Bigfoot Biomedical, Inc. as the automation of the human labor 
required to manage one’s own and other’s type 1 diabetes. “In the right 
circumstances,” the company’s website explains, “a machine can by and large 
make better decisions than humans if given the appropriate information and 
direction.” Unlike people, “machines never tire, never get distracted” (see Bigfoot 
Biomedical, n.d.). Under the moniker of “Bigfoot,” Mazlish is known for 
successfully hacking an insulin pump to work as an automated or “artificial 
pancreas,” a closed-loop system in which data from a continuous glucose monitor 
is used by an insulin pump’s algorithm to make adjustments to insulin dosages. 
Both his wife and son reportedly use his looped system as type 1 diabetics. 
 

References 
Acland, Charles R. 2007. “Introduction: Residual Media.” In Residual Media, edited by 
Charles R. Acland, xiii–xxvii. Minneapolis: University of Minnesota Press. 

Ahmed, Sara. 2007. Queer Phenomenology: Orientations, Objects, Others. Durham, 
NC: Duke University Press. 

———. 2010. The Promise of Happiness. Durham, NC: Duke University Press.  

Akrich, Madeleine. 1992. “The De-Scription of Technological Objects.” In Shaping 
Technology/Building Society: Studies in Sociotechnical Change, edited by Wiebe Bijker 
and John Law, 205–24. Cambridge, MA: MIT Press. 

American Diabetes Association. 2017. “Standards of Medical Care in Diabetes.” 
Diabetes Care 40 (Suppl. 1): S1–S135. 

Archer, Alan. 2014. “Shame and Diabetes Self-Management.” Practical Diabetes 31, 
no. 3: 102–06. 

Arduser, Lora. 2017. Living Chronic: Agency and Expertise in the Rhetoric of Diabetes. 
Columbus: Ohio State University Press.  

Balfe, Myles, Frank Doyle, Diarmuid Smith, Seamus Sreenan, Ruairi Brugha, David 
Hevey, and Ronan Conroy. 2013. “What’s Distressing About Having Type 1 Diabetes? 



 
Original Research                                                

 
 

     | Catalyst: Feminism, Theory, Technoscience 7 (1)                    Carrie Rentschler and Benjamin Nothwehr, 2021 
 

31   

A Qualitative Study of Young Adults’ Perspectives.” BMC Endocrine Disorders 13 (25): 
1–14. https://doi.org/10.1186/1472-6823-13-25. 

Balsamo, Anne. 2011. Designing Culture: The Technological Imagination at Work. 
Durham, NC: Duke University Press.  

Barad, Karen. 2007. Meeting the Universe Halfway: Quantum Physics and the 
Entanglement of Matter and Meaning. Durham, NC: Duke University Press. 

Bergen, Rachel. 2019. “'It Affects Everything': Manitoba Diabetics Want Province to 
Expand Insulin Pump Coverage.” CBC News, December 20, 2019. 
https://www.cbc.ca/news/canada/manitoba/diabetes-manitoba-insulin-coverage-
1.5399708. 

Biagioli, Mario. 2014. “Intangible Objects: How Patent Law is Redefining Materiality.” 
In Objects and Materials: A Routledge Companion, edited by P. Harvey, E.C. Casella, G. 
Evans, H. Know, C. McLean, E.B. Silva, N. Thoburn, and K. Woodward, 378–90. New 
York: Routledge. 

Bigfoot Biomedical. n.d. “The Legend of Bigfoot.” Accessed November 3, 2020. 
https://www.bigfootbiomedical.com/about/the-bigfoot-legend. 

Broom, Dorothy, and Andrea Whittaker. 2004. “Controlling Diabetes, Controlling 
Diabetics: Moral Language in the Management of Diabetes Type 2.” Social Science & 
Medicine 58: 2371–82. https://doi.org/10.1016/j.socscimed.2003.09.002. 

Browne, Jessica L., Adriana Ventura, Kylie Mosely, and Jane Speight. 2014. “‘I’m Not a 
Druggie, I’m Just a Diabetic’: A Qualitative Study of Stigma from the Perspective of 
Adults with Type 1 Diabetes.” BMJ Open, no. 4, 1–10. 

Canadian Diabetes Association. 2013. “Using Insulin.” Ontario Ministry of Health and 
Long-Term Care.  
http://www.health.gov.on.ca/en/public/programs/diabetes/docs/diabetes_factsheets/
English/insulin_diabetes_240314en.pdf 

Connolly, Patrick. 1986. Love, Dad. Kansas City, MO: Andrews, McMeel & Parker. 

Cooperative Patent Classification “A61M.” 2020. Alexandria: United States Patent 
and Trademark Office. 
https://www.cooperativepatentclassification.org/cpc/scheme/A/scheme-A61M.pdf. 

Davis, Lennard J. 1995. Enforcing Normalcy: Disability, Deafness, and the Body. New 
York: Verso. 

“Dean Kamen, Science Advocate, Inventor and Entrepreneur, To Receive 2018 NSB 
Public Service Award.” 2018. National Science Foundation, April 5, 2018. 
https://www.nsf.gov/news/news_summ.jsp?cntn_id=244962&WT.mc_id=USNSF_62
&WT.mc_ev=click. 

Diabète Québec. n.d. “What Is an Insulin Pump?” Accessed November 3, 2020. 
https://www.diabete.qc.ca/en/living-with-diabetes/care-and-treatment/drugs-and-
insulin/insulin-pumps/. 

https://doi.org/10.1186/1472-6823-13-25
https://www.nsf.gov/news/news_summ.jsp?cntn_id=244962&WT.mc_id=USNSF_62&WT.mc_ev=click
https://www.nsf.gov/news/news_summ.jsp?cntn_id=244962&WT.mc_id=USNSF_62&WT.mc_ev=click
https://www.diabete.qc.ca/en/living-with-diabetes/care-and-treatment/drugs-and-insulin/insulin-pumps/
https://www.diabete.qc.ca/en/living-with-diabetes/care-and-treatment/drugs-and-insulin/insulin-pumps/


 
Original Research                                                

 
 

     | Catalyst: Feminism, Theory, Technoscience 7 (1)                    Carrie Rentschler and Benjamin Nothwehr, 2021 
 

32   

Diabetes Care Community. 2015. “Insulin Pump Coverage in Canada.” 2015. Diabetes 
Care Community.ca, February 11, 2015. 
https://www.diabetescarecommunity.ca/living-well-with-diabetes-
articles/medication-articles/insulin-medication-articles/insulin-pump-coverage-in-
canada/. 

Diabetes.co.uk. 2011. “Insulin Pens.” YouTube video, 0:56. April 19, 2011. 
https://youtu.be/v2nvnlyF-1o. 

Diabetes Education Online. n.d. “What Is an Insulin Pump?” Diabetes Teaching Center 
at the University of California, San Francisco. Accessed November 3, 2020. 
https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-
diabetes/medications-and-therapies/type-2-pump-rx/what-is-an-insulin-pump/. 

Diabetes Forecast. 2009. “Insulin Pumps: Some People with Diabetes Use Wearable 
Pumps to Provide Insulin.” January 2009. 
http://www.diabetesforecast.org/2009/jan/insulin-pumps.html. 

Diabetes Forecast. 2019. “Insulin Pens: Consumer Guide.” March 2019. 
http://main.diabetes.org/dforg/pdfs/2019/2019-cg-insulin-pens.pdf. 

Dickinson, Jane K., Susan J. Guzman, Melinda D. Maryniuk, Catherine A. O’Brian, 
Jane K. Kadohiro, Richard A. Jackson, Nancy D’Hondt, Brenda Montgomery, Kelly L. 
Close, and Martha M. Funnell. 2017. “The Use of Language in Diabetes Care and 
Education.” Diabetes Care, no. 40, 1790–99. https://doi.org/10.2337/dci17-0041. 

Disetronic Medical Systems. 2003. “Product Recall: Urgent Safety Information 
Concerning Your D-Tron Pump.” Letter to D-Tron user(s). 
https://archive.childrenwithdiabetes.com/download/DisetronicDTRONNotice.pdf. 

Forlano, Laura. 2016. “Hacking the Feminist Disabled Body.” Journal of Peer 
Production, no. 8. http://peerproduction.net/issues/issue-8-feminism-and-unhacking-
2/peer-reviewed-papers/issue-8-feminism-and-unhackingpeer-reviewed-papers-
2hacking-the-feminist-disabled-body/. 

———. 2017. “Data Rituals in Intimate Infrastructures: Crip Time and the Disabled 
Cyborg Body as an Epistemic Site of Feminist Science.” Catalyst: Feminism, Theory, 
Technoscience 3 (2): 1–28. https://doi.org/10.28968/cftt.v3i2.28843. 

Garland-Thomson, Rosemarie. 1997. Extraordinary Bodies: Figuring Physical Disability 
in American Culture and Literature. New York: Columbia University Press. 

Gessler, Nicholas. 1998. “Skeuomorphs and Cultural Algorithms.” Paper presented at 
Evolutionary Programming VII: Proceedings of the 7th International Conference on 
Evolutionary Programming. Berlin, 1998. https://doi.org/10.1007/BFb0040776. 

Goffman, Erving. 1963. Stigma: Notes on the Management of Spoiled Identity. New 
York: Simon & Schuster, Inc. 

Hall, Rachel, Torin Monahan, and Joshua Reeves. 2016. “Editorial: Surveillance and 
Performance.” Surveillance & Society 14 (2): 153–67. 
https://doi.org/10.24908/ss.v14i2.6375. 

https://youtu.be/v2nvnlyF-1o
https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-therapies/type-2-pump-rx/what-is-an-insulin-pump/
https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-therapies/type-2-pump-rx/what-is-an-insulin-pump/
https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-therapies/type-2-pump-rx/what-is-an-insulin-pump/
https://dtc.ucsf.edu/types-of-diabetes/type2/treatment-of-type-2-diabetes/medications-and-therapies/type-2-pump-rx/what-is-an-insulin-pump/
https://archive.childrenwithdiabetes.com/download/DisetronicDTRONNotice.pdf
http://peerproduction.net/issues/issue-8-feminism-and-unhacking-2/peer-reviewed-papers/issue-8-feminism-and-unhackingpeer-reviewed-papers-2hacking-the-feminist-disabled-body/
http://peerproduction.net/issues/issue-8-feminism-and-unhacking-2/peer-reviewed-papers/issue-8-feminism-and-unhackingpeer-reviewed-papers-2hacking-the-feminist-disabled-body/
http://peerproduction.net/issues/issue-8-feminism-and-unhacking-2/peer-reviewed-papers/issue-8-feminism-and-unhackingpeer-reviewed-papers-2hacking-the-feminist-disabled-body/
https://doi.org/10.28968/cftt.v3i2.28843


 
Original Research                                                

 
 

     | Catalyst: Feminism, Theory, Technoscience 7 (1)                    Carrie Rentschler and Benjamin Nothwehr, 2021 
 

33   

Hamraie, Aimi, and Kelly Fritsch. 2019. “Crip Technoscience Manifesto.” Catalyst: 
Feminism, Theory, Technoscience 5 (1): 1–34. https://doi.org/10.28968/cftt.v5i1.29607. 

Haraway, Donna. 1992. The Promises of Monsters: A Regenerative Politics for 
Inappropriate/d Others. New York: Routledge.  

Hayles, N. Katherine. 1999. How We Became Posthuman: Virtual Bodies in Cybernetics, 
Literature, and Informatics. Chicago: University of Chicago Press. 

Hendren, Sara. 2020. What Can a Body Do?: How We Meet the Built World. New York: 
Penguin Random House LLC. 

Horrocks, Stephen. 2019. “Materializing Datafied Body Doubles: Insulin Pumps, 
Blood Glucose Testing, and the Production of Usable Bodies.” Catalyst: Feminism, 
Theory, Technoscience 5 (1): 1–26. https://doi.org/10.28968/cftt.v5i1.29613. 

Hurley, Dan. 2014. “Diabetes Patients Are Hacking Their Way Toward a Bionic 
Pancreas.” Wired.com, December 24, 2014. 
https://www.wired.com/2014/12/diabetes-patients-hacking-together-diy-bionic-
pancreases. 

International Diabetes Federation. 2014. “International Diabetes Federation 
Language Philosophy: Technical Document.” Brussels: International Diabetes 
Federation. 

Iverson, Cheryl, Stacy Christiansen, and Annette Flanigan. 2007. AMA Manual of 
Style, 10th ed. Oxford: Oxford University Press. 

Jayarag, Kandaswamy, Ellen D. Davis, and Diana McNeill. 2001. “New Therapies for 
Type 1 Diabetes Mellitus.” Ochsner Journal 3 (3): 138–43. 

Kafer, Alison. 2013. Feminist, Queer, Crip. Bloomington: Indiana University Press. 

Kamen, Dean. 1975a. Control Device for a Monitor Supervising a Patient. U.S. Patent 
3,871,361, filed March 11, 1974, and issued March 18, 1975. 

———. 1975b. Medication Injection Device. U.S. Patent 3,858,581, filed July 2, 1973 
and issued January 7, 1975. 

Latour, Bruno. 1988. “Mixing Humans and Nonhumans Together: The Sociology of a 
Door-Closer.” Social Problems 35 (3): 298–310. 

Liu, Nancy F., Adam S. Brown, Alexandra E. Folias, Michael F. Younge, Susan J. 
Guzman, Kelly L. Close, and Richard Wood. 2017. “Stigma in People with Type 1 or 
Type 2 Diabetes.” Clinical Diabetes, no. 35, 27–34. 

Love, Heather. 2015. “Stigma.” In Keywords for Disability Studies, edited by Rachel 
Adams, Benjamin Reiss, and David Serlin, 173–75. New York: New York University 
Press. 

Lucherini, Mark. 2016. “Performing Diabetes: Felt Surveillance and Discreet Self-
Management.” Surveillance & Society 14 (2): 259–76. 

https://doi.org/10.28968/cftt.v5i1.29607
https://doi.org/10.28968/cftt.v5i1.29613
https://www.wired.com/2014/12/diabetes-patients-hacking-together-diy-bionic-pancreases/
https://www.wired.com/2014/12/diabetes-patients-hacking-together-diy-bionic-pancreases/


 
Original Research                                                

 
 

     | Catalyst: Feminism, Theory, Technoscience 7 (1)                    Carrie Rentschler and Benjamin Nothwehr, 2021 
 

34   

McAdams, Brooke H., and Ali A. Rivzi. 2016. “An Overview of Insulin Pumps and 
Glucose Sensors for the Generalist.” Journal of Clinical Medicine 5 (1): 1–17. 
https://doi.org/10.3390/jcm5010005. 

Medtronic. 2017. MiniMed 670G System Brochure. 
https://www.medtronicdiabetes.com/sites/default/files/library/download-
library/references/MiniMed_670G_System_Brochure.pdf. 

Mol, Annemarie. 2009. “Living with Diabetes: Care Beyond Choice and Control.” 
Lancet 373 (9677): 1756–57. https://doi.org/10.1016/S0140-6736(09)60971-5. 

Mol, Annemarie, and John Law. 2004. “Embodied Action, Enacted Bodies: The 
Example of Hypoglycaemia.” Body & Society 10 (2/3): 43–62. 

Morris, Jeremy W. 2015. Selling Digital Music, Formatting Culture. Berkeley: University 
of California Press. 

Murphy, Michelle. 2012. Seizing the Means of Reproduction: Entanglements of 
Feminism, Health, and Technoscience. Durham, NC: Duke University Press.  

New York Times. 1986. “A Father’s Memorial Is His Own Messages of Love.” August 
23, 1986. https://www.nytimes.com/1986/08/23/style/a-father-s-memorial-is-his-
own-messages-of-love.html. 

Novo Nordisk Pharmaceuticals, Inc. 2002. “Insulin Pump Therapy: Is It Right for You?” 
December 2002. http://www.insulin-pumpers.org/faq/novopump.pdf 

Pihlaskari, Andrea K., Barbara J. Anderson, Sahar S. Eshtehardi, Brett M. McKinney, 
David G. Marrero, Debbie Thompson, and Marisa E. Hilliard. 2020. “Diabetes 
Disclosure Strategies in Adolescents and Young Adults with Type 1 Diabetes.” Patient 
Education and Counseling 103 (1): 208–13. https://doi.org/10.1016/j.pec.2019.08.019. 

Pottage, Alain. 2011. “Law Machines: Scale Models, Forensic Materiality and the 
Making of Modern Patent Law.” Social Studies of Science 41 (5): 621–43.  

Pullin, Greg. 2009. Design Meets Disability. Cambridge, MA: MIT Press. 

Rex, Jørn, and Otto A. Vogeley. 1986. Dispenser. U.S. Patent 4,592,745, filed 
February 29, 1984, and issued June 3, 1986. 

Rex, Jørn, Klaus H. Jensen, and Simon A. Lawton. 2006. “A Review of 20 Years’ 
Experience with the NovoPen Family of Insulin Injection Devices.” Clinical Drug 
Investigation 26 (7): 367–401. https://doi.org/10.2165/00044011-200626070-00001. 

Samuels, Ellen. 2003. “My Body, My Closet: Invisible Disability and the Limits of 
Coming-Out Discourse.” GLQ 9 (1/2) 233–55. 

Squibb-Novo, Inc. 1986. State-of-the-Art Diabetes Care. NovoPen® booklet. Catalog 
number NMAH-AHB2012q0689, Division of Medicine and Science, National Museum 
of American History, Smithsonian Institution, Washington, DC. 

Squibb-Novo, Inc. 1986a. "Convenient, Discreet, Accurate.” In State-of-the-Art 
Diabetes Care. 1986. NovoPen® booklet. Washington, DC: Division of Medicine and 

https://doi-org.proxy3.library.mcgill.ca/10.1016/j.pec.2019.08.019


 
Original Research                                                

 
 

     | Catalyst: Feminism, Theory, Technoscience 7 (1)                    Carrie Rentschler and Benjamin Nothwehr, 2021 
 

35   

Science, National Museum of American History, Smithsonian Institution. NMAH-
AHB2012q06898. 

Squibb-Novo, Inc. 1986b. “Discreet, Convenient, Helpful.” In State-of-the-Art Diabetes 
Care. 1986. NovoPen® booklet. Washington, DC: Division of Medicine and Science, 
National Museum of American History, Smithsonian Institution. NMAH-
AHB2012q06899. 

Star, Susan L. 2010. “This Is Not a Boundary Object: Reflections on the Origin of a 
Concept.” Science, Technology, and Human Values 35 (5): 601–17. 

Star, Susan L., and James R. Griesemer. 1989. “Institutional Ecology, ‘Translations’ 
and Boundary Objects: Amateurs and Professionals in Berkeley’s Museum of 
Vertebrate Zoology, 1907-39.” Social Studies of Science 19 (3): 387–420. 

Star, Susan L., and Karen Ruhleder. 1996. “Steps Towards an Ecology of 
Infrastructure: Design and Access for Large Information Spaces.” Information Systems 
Research 7 (1): 111–34. 

Sterne, Jonathan. 2020. “The Software Passes the Test When the User Fails It: 
Constructing Digital Models of Analog Signal Processors.” In Testing Hearing, edited 
by V. Traczyk, M. Mills, and A. Hui, 159–85. New York: Oxford University Press. 

Tandem Diabetes Care, Inc. 2020. “t:slim X2 Insulin Pump” 
https://www.tandemdiabetes.com/docs/default-source/product-documents/t-slim-
x2-insulin-pump/ml-1007630_a---print-patient-pack-control-iq-
canada5874789775426a79a519ff1100a9fd39.pdf?sfvrsn=bdfd04d7_15  

Tzemis, Peter. 2020. “Ranking the Best Insulin Pens: 2020.” CPOE.org, May 26, 2020. 
https://cpoe.org/insulin-pens/. 

Umpierrez, Guillermo E., and David C. Klonoff. 2018. "Diabetes Technology Update: 
Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital." Diabetes 
Care 41 (8): 1579–89. https://doi.org/10.2337/dci18-0002. 

Vitellone, Nicole. 2003. “The Syringe as Prosthetic.” Body & Society 9 (3): 37–52. 

Wendell, Susan. (2001) 2017. “Unhealthy Disabled: Treating Chronic Illnesses as 
Disabilities.” Hypatia 16 (4): 17–33. Republished in The Disability Studies Reader, 5th 
ed., edited by Lennard Davis, 160–74. New York, NY: Routledge. Citations refer to the 
Routledge edition. 

Wenger, Mitchell, Mark C. Estes, and Scott Chiang. 2016. Portable Infusion Pump and 
Media Player. U.S. Patent 9,314,566 B2, filed September 3, 2012 and issued April 19, 
2016. 

“What Someone is Probably Thinking When They See My Insulin Pump.” 2018. 
Meme. Accessed November 3, 2020. https://me.me/i/what-someone-is-probably-
thinking-when-they-see-my-insulin-22122611. 

Williams, Raymond. 1977. Marxism and Literature. Oxford: Oxford University Press.  

 

https://me.me/i/what-someone-is-probably-thinking-when-they-see-my-insulin-22122611
https://me.me/i/what-someone-is-probably-thinking-when-they-see-my-insulin-22122611
https://me.me/i/what-someone-is-probably-thinking-when-they-see-my-insulin-22122611


 
Original Research                                                

 
 

     | Catalyst: Feminism, Theory, Technoscience 7 (1)                    Carrie Rentschler and Benjamin Nothwehr, 2021 
 

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Author Bios 
Carrie Rentschler is an Associate Professor in the Department of Art History and 
Communication Studies and an Associate Member of the Institute for Gender, 
Sexuality & Feminist Studies at McGill University. Her research examines how 
feminist movements respond to gender violence and the politics of care and 
witnessing they enact via social media networks and in backchannel forms of 
communication. She also researches the legacies of type 1 diabetes in the 
practices and technologies of the quantified self.   
 
Benjamin Nothwehr is a graduate student in Communication Studies with a 
particular interest in queer and transgender cultural production. Their current 
research examines how queer and trans artists engage archival material in their 
work to produce speculative historiographies and alternative archival logics that 
intervene in public memory and provide new models of historical identification 
and kinship.