To Tell or Not to Tell, That is the Question

By Joe Nelson | January 3, 2007 10:47 am

So, who knows you have diabetes? Whom do you tell that you take medicine or monitor your blood glucose levels? How do you tell someone that you are dealing with a chronic medical condition that might have acute issues? What are you afraid they might do or think?

These are just a few of the questions that you are likely to consider when living with diabetes. These questions come up at work, in relationships, in friendships, and even in families, and most of the time there is no right answer. There is only the answer that is right for you and this comes only after great thought.


You might be someone who says “This is no big deal, just tell everyone.” While this may indicate that you have self-confidence and don’t care what others think of you, this approach may also leave you open to misunderstanding, judgment, and “special” treatment from others who don’t really understand diabetes. On the other hand, you may be someone who refuses to tell anyone, never wanting to be vulnerable to others’ misconceptions and judgments. But this self-reliance can leave you in a position of always having to be on guard lest someone find out about your condition.

In the case of a workplace environment, being dishonest about diabetes could be grounds for termination. However, the fear of experiencing discrimination based on having diabetes is very real, as some people have lost their jobs and others have been placed in lower-paying positions because of bias about diabetes. The other unspoken reality relates to the private judgments supervisors may have about diabetes. This can ultimately affect promotions, raises, and projects people are assigned.

The other side of this issue is the need for health, safety, and support in the workplace. There is little question that caring for your diabetes requires attention to food, medicine, and blood glucose monitoring. This attention is necessary at work as well, so unless you are going to skulk around in a secretive fashion, someone needs to know about what you are doing. And if you take medicines that put you at risk for hypoglycemia, it is critical that someone else understand the basics of diabetes so they can provide you with assistance if needed.

The statistical truth about diabetes for employers is not pretty. Among people with diabetes there is a higher rate of absenteeism and a greater risk for depression, which is a leading cause of sick days. While these are statistical facts, people who have diabetes have the same work capabilities as people who don’t and may even feel a little extra pressure to perform well because of their diabetes. They also have some legal protections under federal law.

Another area in which I’ve seen people who have diabetes struggle with the question of “To Tell or Not to Tell?” is early in relationships. Not knowing what others think about diabetes, how they are likely to respond, or if they will treat you differently can put you in a real bind. You will never know what will happen unless you tell, but once you’ve told, it’s too late to take it back.

So, what do you do? Do you have a policy for how to open this issue up? What is the determining factor for you—your comfort, your mood, your blood glucose level?

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Joe Nelson: oe is a psychotherapist in private practice in Minnesota, where he specializes in the psychology of chronic disease and sexual problems and works with couples, families, children, and teens. He has been a Licensed Psychologist since 1985 and has earned a master’s degree from St. Mary’s College Winona, a bachelor’s degree in social work from the University of Minnesota, and an associate’s degree in human services from the College of DuPage in Glen Ellyn, Illinois.

Joe has worked with troubled youth in Chicago and Minnesota and on a special project on Turtle Mountain Reservation in North Dakota. He was the first social worker hired by an affiliate of the American Diabetes Association. He worked at the International Diabetes Center for 20 years, directing psychological services there for 12 years. A Certified Sex Therapist, Joe co-developed the Sexual Health Center at Park Nicollet Clinic.

Having practiced meditation for over 30 years, Joe offers instruction in mindfulness-based meditation to patients in groups and as individuals. Joe is married, has a 23-year-old daughter, and enjoys scuba diving, motorcycling, golf, and being outdoors doing almost anything.

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