Diabetes Self-Management Blog

Did you ever notice how a lot of people teach the things they aren’t good at? Like ex-drug addicts who go around warning kids about the dangers of drugs. That’s why, for example, a lot of preachers tend to be among the worst sinners.

Well, I’m the same way.

I’m always telling people to speak up for themselves, to be assertive. “Don’t say yes when you want to say no.” “Let people know what you really want.” “Don’t put other people’s wants ahead of your own needs.” I say things like that and wrote about them in my book The Art of Getting Well and on some Web sites.

But do I speak up for my own self? Not very often, I’m afraid. I’ve always been a passive sort of guy who tries to avoid trouble. There’s a place for “going along to get along,” but dealing with a chronic illness is not that place. Now that “niceness” is causing problems in a couple of places.

My partner, Aisha, likes to tell me about her life at some length. I don’t mind listening for a while, but I get tired or have other things to do. But I’m not good at gently letting her know that I’ve had enough. I’m afraid of hurting her feelings or making her mad.

There’s a similar issue with this Web site I work on (not DSM). We have these phone meetings where some of the people go on and on without getting to the point. It makes me really tired. I do put the phone down sometimes and just rest. (They rarely notice.) But I haven’t figured out how to tell them to shut up. (Nicely, of course—they are paying me.)

Speaking up With Diabetes
I think that these issues apply a lot of times in living with diabetes. How do you tell your aunt you don’t want to eat the cake she baked for you? How do you explain that you’re going for a walk after dinner instead of watching the sitcom with your family? Or explain to your boss that you are going to take your break even if it’s busy, or whatever.

Is that right? Do you find assertiveness to be an important part of self-management? What kind of advice can you give me and our readers? I’m especially interested in hearing from people who didn’t speak up for themselves but have now learned how to do it. Comment here, or visit me at www.davidsperorn.com.


  1. Doctors are not mind readers so when dealing with any health care provider it is essential that we tell them assertively what is going on in some detail. Most people freeze up when in the doctor’s office so I educate patients to keep a journal or at least a list of problems or concerns to discuss.We have a right to respectful care so if any health care provider is rude or condesending I would likely tell them I don’t want them taking care of me or my family. Time is limited in appointments so be assertive and organized in what you need to say to get the treatment you need.

    Posted by mleafrn |
  2. As far as being assertive, I just do what I need to do to make me healthy. When someone cooks food for me that I can’t eat, I gently remind them that I can’t eat it, but it looks great. I take my walks during work by getting in 30 minutes early and using those 30 minutes later in the day to take a morning walk and an afternoon walk. My boss understands that if I don’t walk, I will get sicker and miss work. It’s in everyone’s best interest that I take care of myself.

    Posted by shellys |
  3. I think of two things when I think of being assertive: assertiveness and aggressiveness. Mostly because many of the more passively-natured people think being assertive is akin to being aggressive. The difference between the two is something that needs to be understood, and once understood makes moving toward being assertive easier. Actually, that passive part of us is why we need the skills to be assertive; it’s uncomfortable when people “walk all over us”.

    Being assertive is just this: simply stepping up and assuring you get what you need without malice toward the other person. No anger or bad will, it is simply: “this is what I need and why”.

    We all know what aggressiveness is, and we don’t like it or want to be like that. We choose instead to be assertive by being neutrally expressive of our needs and rights.

    This thought is based on the fact that I actually use certain methods to be assertive, and that way I feel I have done what I can on my own behalf. I tend also to do it for others who are underdogs as well.

    Pilot Mark

    Posted by Pilot Mark |
  4. Tell my aunt “no thanks” to her cake? NO WAY. Take it and share it with the rest of the family. YES. Keep a small portion, cut into small servings in my freezer for those special treats! ABSOLUTELY. I always have something “naughty” in my freezer, it keeps me from really splurging out of control.

    Now, at family get-togethers and food I don’t choose to eat is cooked, well, I can always bring something myself that I CAN eat. Happens every Christmas and Thanksgiving.

    I’ve even eaten my cery very low carb meal at home then showed up in time for dessert at birthday get-togethers and joined in for a small piece of cake (icing scraped off) and cup of coffee before gifts were opened.

    One thing I’ve found is that as I get older, I get more assertive I’m not the doormat I used to be.

    Posted by Ephrenia |
  5. Thanks, everyone for these great stories of assertiveness. As Ephrenia said, it does seem to take a lot of growing (or aging) for many of us to stop being doormats. But it’s better if we get there sooner.

    Posted by David Spero RN |

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