“Bad Diabetic”: Diabetes and the Shame Game

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"Bad Diabetic": Diabetes and the Shame Game

I was online searching for a topic for this week’s blog entry when I read a comment in a forum that really struck me in a deep way. I won’t directly quote, of course, but the gist of the comment was summed up with the words, “[I am] the worst diabetic ever.” The writer was clearly despondent, and felt that he was simply doing everything wrong. This individual was relatively new to our delightful world of diabetes, and I’m proud to say that follow-up comments were all hugely supportive and encouraging. In any event, I can relate to what he was feeling, as can most of us, I’m sure.

Our daily blood sugar readings (which we get every few hours or every five minutes with a continuous glucose monitor) and that all-important A1C feel like daily homework followed by the “end-of-semester-exam.” It feels like a direct reflection on “how well” we’ve managed our disease. A doctor reporting our high A1C can easily sound like a doctor saying, “you’re bad at diabetes; maybe not the worst I’ve seen, but verrry subpar — you get a D- in this class.” Our daily blood sugar readings can feel like a series of poorly graded papers. It can feel like a succession of personal failures, and it invites an of onslaught of self-shame that led the poor gentlemen I was telling you about to label himself a bad diabetic.

Here’s the truth: There’s no such thing as a “bad diabetic.” I mean it. Even folks who neglect their doctor’s advice, ignore their own best interests, and engage in willfully destructive behaviors; they’re not “bad diabetics.” We’re not “bad diabetics” because this disease is NOT an academic class, or a job, or an endeavor we decided to take on. This disease is something we were saddled with by sheer luck of the draw, and now we have to deal with it. We’re not performing for a grade here, we’re living with a challenging burden.

Of course, the majority of us DO try our best, but sometimes even that doesn’t give us the “correct” results. And that’s when the real shame can start up — when we’ve tried our best, done everything we KNOW to do, and still don’t see the numbers on our little meter screens that we feel we “should” be seeing. It’s just so disheartening, and the temptation is strong to either beat ourselves up for not being “smart enough,” or perhaps to lash out at our own “dysfunctional” bodies for failing to respond correctly to our interventions (as if our “body” is somehow a thing detached from our mind — attacking our “dysfunctional” body is just as much an act of self-shaming as calling ourselves “stupid”).

What we can do
So the question is, what can we do about our tendency to shame ourselves? Above all, we can remember that diabetes is a disease involving a monumentally complex system of hormones, proteins, and internal bodily functions that we now have to handle “manually.” Fellow blogger David Spero wrote an excellent blog entry on just how complex the job of insulin really is — it’s way more than just a “way to get sugar out of the bloodstream.” Expecting such a complex, dynamic, and living system to always respond the same way is setting yourself up for failure. Your body WON’T respond the same way all the time. Your body won’t respond to the insulin you give yourself with breakfast the same way it will to the insulin you give yourself for dinner. Your hormonal balance will have shifted by then. You will have engage in different activity. Your stress level will have shifted. All of this affects how your body will behave and what kind of number you’ll see on that precious little meter.

We can establish a mindfulness practice to increase our ability to keep a cool head and calm mindset when things ARE going “wrong.” Such a practice needs to be consistently attended to and thoughtfully cultivated, but it’s worth the time and effort.

Finally, we can just cut ourselves some slack and remind ourselves that “perfect” control doesn’t exist. Nobody, in the entire history of diabetes, has had “perfect” control. Nobody. So don’t aim for perfect. Aim for good. And don’t beat yourself up when your tactics don’t work. Sometimes the exact “right” steps can lead to downright horrible blood sugars. The reasons are many, and often a mystery. That’s just part of this disease. So don’t shame yourself; don’t label yourself a “bad diabetic.” There’s no such thing.

A new study indicates that prediabetes might be more damaging to motor nerves than once believed. Bookmark and tune in tomorrow to learn more.

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