Chasing blood sugars: Metaphor, agency, and community knowledge in the Juicebox Podcast

Abstract

This paper examines how people with Type 1 Diabetes (T1D) use metaphor to construct agency, identity, and shared understanding within The Juicebox Podcast, an international platform for patient dialogue. It aims to show how figurative language mediates between data, emotion, and lived experience, transforming individual management into collective expertise. An embedded singlecase study was conducted on 81 podcast episodes (≈ 953,000 words). The analysis combined Conceptual Metaphor Theory (Lakoff & Johnson, 1980), the Discourse Dynamics Approach (Cameron, 2003, 2011), and Critical Metaphor Analysis (CharterisBlack, 2004, 2011, 2018) to identify salient metaphors and explore their cognitive, pragmatic, and ideological functions. Recurring metaphors conceptualise T1D as mathematics, a journey, a machine or broken object, and a personified agent. These patterns reveal how participants negotiate control, responsibility, and relationality while resisting biomedical hierarchies. The conversational medium enables real-time metaphor negotiation, fostering empathy and peer learning. Metaphor emerges as both a cognitive tool and a social practice: it translates quantifiable data into meaningful experience, builds community knowledge, and reinforces patient agency. The study demonstrates the value of qualitative, discourse-based methods for understanding chronic-illness communication in digital contexts.