A Guide for the Friends of People With Diabetes

I was at a bar with my friend about a month ago. We had just eaten dinner, my blood sugar was around 86 and on the downward-moving end of the curve, and I was ordering a single beer. The bartender, after spying me testing my blood sugar, gave me that line that makes ALL US DIABETIANS CRINGE: “You’re diabetic, you shouldn’t have beer. My friend is diabetic.” I calmly explained that no, diabetes does not mean I “can never drink a beer,” it means something much more complex than that, I’ve been managing it for 22 years, I just finished testing and, yes, I CAN HAVE A BEER, thank you very much! Even writing it now, a month later, I feel myself getting a little angry.

Now, I’m sure this snarky bartender meant well. Sure, she was crossing a bit of a personal boundary, but in her heart of hearts she may have been genuinely convinced that I wasn’t taking proper care of myself. But here’s the thing — it wasn’t her place to interfere in my life like that! It was rude, and it was thoroughly patronizing and belittling! And, to be honest, it really pissed me off. But instead of letting that go completely, or stewing in it and getting annoyed all over again, I thought I could use that little incident as motivation to write what I hope will be a helpful guide for the friends and family (and the strangers who have chance encounters) of people with diabetes. It’s not terribly complicated as long as you follow some key guidelines.

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Rule 1: We KNOW we have diabetes, you don’t need to tell us
There is a kind of arrogance that goes along with telling someone, “you have diabetes, you have to do X.” It presumes that this person you’re talking to, who has lived with this disease 24 hours a day for who knows how many years, somehow knows less about how to care for themselves than you do. We know what we should and shouldn’t do. We know it better than you. That’s not me being petulant, that’s just fact. We live with this thing nonstop, and we understand how it works. If you see someone with diabetes doing something that you feel genuinely concerned about, I suggest you make one simple but VERY IMPORTANT change in your approach. Don’t go tell them what they should be doing — that’s rude, belittling, and patronizing beyond belief. If you’re genuinely worried, ASK THEM if the action they’re taking is going to cause them harm. And if you’re not actually concerned about any serious outcome but just feel like giving general, unsolicited health advice, I have an even simpler suggestion: don’t. Really, just let us be adults and make our own choices.

Rule 2: Except when we’re low
OK, I just got done telling you to let us live our lives and stay out of our decisions. There’s one major exception: If we’re low, make sure we get sugar IMMEDIATELY. How can you tell we’re low? If you talk to us and we’re making no sense, you see us beginning to shake or show signs of hypoglycemia, do whatever you have to in order to get sugar into our system immediately. This is the ONLY time I’m going to be giving you this advice. And if you talk to us and we just seem a little bit off? Well, refer back to Rule 1 and ASK US if we might be low. My wife and my friends will ask me this often enough. My wife in particular has become incredibly good at spotting even minor low blood sugars. My bandmates will make the same inquiry if I seem a little “off.” When they do, I’ll test. It’s pretty simple.

Rule 3: Living with diabetes doesn’t mean living in a bubble; it means living responsibly
We Diabetians can do pretty much anything you can; we just might need a few extra minutes here and there. We can eat most anywhere, but it’s really nice to know a little ahead of time so that we can test and make sure we time our insulin correctly. We can go for a hike, but we have to make sure we’ve got our tester and sugar with us in case the exercise causes our blood sugar levels to drop. We can go camping for five days in the mountains, but we better have extra supplies, a way to keep our insulin from baking, and a spare tester in case our primary one dies on us. You get the idea. Diabetes is a disease that can be managed, and we don’t have to live our lives in a sealed bubble. We don’t live in iron lungs, but we have to be prepared. We can be just as adventurous as anyone else; we just can’t be reckless.

Wrap-up
There you go, three basic rules. I told you it was simple. In the end, what I’m really saying is this: Yes, diabetes is a serious condition, and if you genuinely fear for our safety in a given situation, you should take action. You should ask us if we’re OK, and if you suspect we’re suffering low blood sugar, make sure we have some sugar and ask us to test. But we’re adults. We know how this disease works. And we have a right to make our own choices and our own decisions. If it’s not a matter of immediate low blood sugar, don’t tell us what “diabetics can’t do,” don’t talk to us like we’re children trying to get away with something when we eat something you don’t think we should, and don’t patronize us. Support us, ASK us about what we’re doing if you’re concerned instead of TELLING us what to do, and give us the same dignity you would offer to any adult. And if the bartender I encountered a month ago ever reads this, please — take this advice with you and use it the next time someone with diabetes wanders into your bar!

Sedentary behavior is associated with diabetic retinopathy, according to new research. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.