Hormonal Intra-Actions in Automated Diabetes Care
4th session of CEFRES in-house seminar
Through the presentation of works in progress, CEFRES’s Seminar aims at raising and discussing issues about methods, approaches or concepts, in a multidisciplinary spirit, allowing everyone to confront her or his own perspectives with the research presented.
Location: CEFRES Library and online (to get the link, write to cefres[@]cefres.cz)
Date: Tuesday, December 16, 2025 at 16:30
Language: English
Speaker: Sabina VASSILEVA (CEFRES / Charles University)
Discussant: Kateřina KOLÁŘOVÁ (Faculty of Humanities, Charles University)
Abstract
This paper explores how people living with Type 1 diabetes attend to hormonal variability by translating hormonal intra-actions into diabetes technologies. Hybrid closed-loop systems—often called “artificial pancreas”—combine continuous glucose monitoring sensors, insulin pumps, and self-learning algorithms, and promise a transition in diabetes care toward automation and reduced burden by distributing control in the loop. Yet, the commercial systems often fail to accommodate cyclical hormonal fluctuations associated with the menstrual cycle or menopause. Even though clinical evidence acknowledges the effects of elevated estrogen levels on insulin resistance and higher glycemia (Brunerová, et al. 2023), and increasing numbers of clinical trials include menstrual cycle as a variable (Levy, et al., 2022; Elhenawy, et al., 2024; Mesa, et al., 2024), these hormonal intra-actions remain sidelined both in clinical practice and algorithmic design.
Drawing on ongoing ethnographic research with users of both commercial and open-source patient developed loops, and health professionals, Sabina Vassileva examines how they engage in hormonal-algorithmic tinkering. How are estrogen, progesterone, or cortisol translated into algorithmic settings? How is the relationship between diabetes and hormones enacted despite not being accounted for by the commercial loops design? Drawing upon the notions of metabolic and hormonal thinking (Landecker, 2024; Ford, et al., 2024), she argues that by these translations users do not simply adapt technology to their individual needs, but moreover transgress the gender normative assumptions embedded in the loop, incorporating gendered embodiments into algorithmic care. In doing so, hormones emerge as biosocial actors mediating between bodies, technologies, and gendered relations, making diabetes experientially visible as a biosocial condition.
Please find the complete program of 2025–2026 seminar here.