Diabetes Self-Management Articles

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Whose Diabetes Is It, Anyway?
Dealing With Resistance, Denial, and Unsolicited Advice

by Scott Coulter, LSW

The way to handle this kind of advice can vary depending on who is giving it. But a few fundamental rules apply. First and foremost, remember that no suggestion should be taken up without a conversation with your doctor. Simply responding with a friendly but firm, “Thank you for the advice, but I really need to talk to my doctor before I do anything like that” can be a good start. For casual acquaintances and people you won’t regularly see, that may be all you need to say. For close friends and family members who offer this kind of advice regularly, a more in-depth conversation may need to take place. Start with a sincere “thank you” for the well-intentioned advice, and then use it as an opportunity to educate your would-be helper a little. You can explain how insulin works, how you calculate carbohydrates for each meal and snack, how your blood glucose monitoring fits in with how you eat, and other details about how your diabetes really works.

For any readers who are inclined to offer this kind of advice to others, here are a few fundamental rules to follow:

1. Never suggest a regimen which asks a person with diabetes to change or stop his current medical course of treatment.

2. Take the time to research what you are suggesting, and learn about what diabetes is before you look into any kind of treatment suggestion.

3. Understand that alternative methods, diets, and other treatments should always be seen as something to be done in addition to standard medical treatment. They should never interfere with or replace that standard treatment.

4. Lastly, understand that someone who has diabetes should never undertake medical treatment of any kind without talking to his health-care team first, so don’t expect your friend or acquaintance to take up any suggestion right away.

No, no, Bob; He’s diabetic…
It is not uncommon for people with diabetes to receive diabetes-related advice that crosses the line from helpful to overbearing. What do you do when you’ve taken insulin for a reasonable dessert, your blood glucose isn’t high, you calculated the carbohydrate for the dessert, you know it’s OK to eat, and you are assailed with scrutiny, concern, and advice from others at the table, along the lines of “Oh, you can’t have that; it has sugar in it!” or “Are you sure you don’t want me to get you some diet pudding?”

This kind of advice can be very irritating. It can feel intrusive, judgmental, and, above all, belittling. As an adult, you are free to make your own choices, and having diabetes does not change that. When you’re living with a serious chronic medical condition, your friends and family will be concerned for your health and welfare, but that doesn’t mean you should not be entitled to make your own choices.

Your best option for confronting this is a direct, honest conversation. You probably won’t receive a lot of this kind of advice from strangers or people you’re meeting for the first time at a party. It’s not like you wear a sign that says “Diabetic,” and your opening line of conversations probably isn’t, “Hi, I’m John and I’m diabetic.” So this is a conversation you’ll most likely be having with friends and family. As always, start by thanking them for their support (even if they’re going a little overboard with it). Make sure they understand that you are not rejecting them as people, but simply want to address how they can be supportive in a way that is helpful for you. They may need a bit of education on what diabetes is and what it means to live with it on a day-to-day basis. They may need some guidance about what they can do to be helpful. The most important thing to remember during this conversation is to address the specific behaviors that are bothering you without making accusations or hurtful remarks.

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