7 Things Not to Say to Someone With Diabetes

For the more than 29 million Americans who have diabetes, living with the disease is challenge enough. However, awkward, ill-informed or insensitive remarks can add to the difficulties faced.

Well-meaning friends, family members, co-workers or strangers can inadvertently make comments that can be judgmental or are based on stereotypes or myths about diabetes. To address misconceptions, it’s important to know what not to say to someone with diabetes. Based on my experiences as a certified diabetes educator and registered dietitian, here are some of the most common diabetes faux pas, paired with the facts and advice on how best to show your support:

1. “Why do you have diabetes – did you eat too much sugar?” Diabetes is not caused by eating too much sugar. Diabetes and its risk factors are complicated. Type 1 diabetes is caused by an autoimmune response in your body (the body’s immune system attacks itself), genetics and still-to-be discovered factors that trigger its onset. Right now, we have no way to stop the onset of Type 1 diabetes. The onset of Type 2 diabetes is caused by a combination of genetics, lifestyle and many unknown factors. While research has shown that, for some, we can prevent or delay Type 2 diabetes, there is no single cause for diabetes.

2. “Are you sure you should be eating that?” People living with diabetes have to think about what they eat for every meal and snack. However, there is no such thing as the “diabetes diet.” A well-balanced diet is recommended for everyone, not just for people with diabetes. It’s best to avoid giving unsolicited advice if you’re trying to help someone meet their nutrition goals. Instead, show your support by making healthy food choices yourself and by having healthy food options available when sharing a meal.

3. “You don’t look like you have diabetes.” Do not assume there is a certain look for diabetes. While being overweight can raise a person’s risk of developing Type 2 diabetes, many people with Type 2 diabetes are not overweight or obese. Anyone can have diabetes.

4. “Oh, you have to take insulin. Do you have the bad type of diabetes?” Diabetes affects each person differently. It’s a common misconception that a person who requires insulin injections has a more severe form of the disease, as compared to someone who takes pills or manages their diabetes with diet and exercise alone. People with Type 1 diabetesneed to take insulin multiple times every day because their body does not produce any insulin. People with Type 2 diabetes do produce insulin. However, Type 2 diabetes can change over time, and medication needs may change and one may require insulin to keep their blood sugar in a healthy range. There is no good or bad type of diabetes. Neither does taking insulin or any diabetes medication reflect how well a person manages their diabetes or signal any type of failure. Everyone with diabetes has different needs, and by working with their health care team, they can determine the best food, activity and medication plans for them.

5. “I didn’t know you’re diabetic.” Although this statement may be said in a caring manner, calling someone “diabetic” appears to label them by their chronic illness. Some find this stigmatizing and offensive. Rather, say, “I didn’t know you have diabetes.”

6. “Your blood sugar is high. Did you do something wrong?” Blood sugar levels are key in making diabetes management decisions. That being said, glucose levels are not an indicator of success or failure, but one of many metrics monitored to provide feedback. Keep in mind that there are many variables that affect blood sugar levels, some of which are beyond a person’s control. Instead of asking someone if they did something “wrong,” offer positive, encouraging support.

7. “I hope you don’t get diabetes complications like my aunt.” People with diabetes are well aware of the potential complications of the disease. You do not need to highlight them. Listen to the person in your life who has diabetes, and hold off on sharing stories about unfortunate complications your friends and loved ones may have experienced. Many advances in diabetes care have greatly reduced the rates of complications. Healthcare teams and diabetes education programs can help guide and support each person with diabetes and their family members to determine the best care plan for each individual.