Managing your health when you’re living with diabetes can be a challenge. It doesn’t help when people around you have opinions about what you should be doing better, writes NYAREE LAWLER.

Managing diabetes isn’t always easy. You might do and eat exactly the same thing for two days in a row and get quite different glucose readings.

Many people living with diabetes report feeling judged by others who haven’t personally experienced the difficulties of managing the condition. It’s often a case of little knowledge proving dangerous (or, at least, unhelpful) to those on the receiving end of that judgement.

A 2021 community survey commissioned by Diabetes Australia found that:

• 85% of people in the community believe people with diabetes shouldn’t eat sugary foods or drinks at all
• A majority of people believed all people with diabetes are overweight.

It shouldn’t need saying, but neither of those judgements is accurate. The research also looked into the sort of stigma people with diabetes had personally faced. It found:

• 52% of people with type 2 diabetes say people assume they are overweight, or have been overweight in the past
• 37% of people with type 2 diabetes say people judge them for their food choices
• 26% of people with type 2 diabetes have been told they brought it on themselves
• 67% of people with type 1 diabetes say they are judged if they eat sugary foods or drinks
• 55% say some people assume it is their fault that they have type 1 diabetes
• 31% don’t tell other people they have type 1 diabetes, to avoid negative reactions.

This survey is just one of many to identify the high percentage of people with diabetes who have experienced judgment about having diabetes and also how they are managing their health. These episodes of judgement – from ‘looks of contempt’ to comments such as ‘should you really be eating that?’– can cause people with diabetes to experience feelings of guilt, embarrassment, anxiety, blame and low self-esteem.

In turn, these negative feelings can affect diabetes management, making people with diabetes less likely to monitor their diabetes or use insulin in public, talk about their diabetes, or seek health professional support, especially if their glucose levels are out of target. People with diabetes who experience diabetes stigma and judgement, report that it adversely affects their social and emotional wellbeing as well as their diabetes management.

While you don’t have any control over what other people think and say, there are things you could do to help reduce the potential negative impact that other people’s judgement might have on how you manage your diabetes.

• Small changes can make a big difference. Realistic and achievable goals are more likely to be maintained over a longer period and can help to increase your confidence in managing your diabetes.
• Focus on what is important to you. You might choose to share this with your family or health care team so they can support you in your decisions.
• Your family and health care team may have their own ideas about what you should be doing to manage your diabetes. Sharing what you want to focus on and what your goals are might help to avoid conflict and judgement.
• Remember that there are many factors that can influence our health and some of them we can’t do anything about, e.g. getting older. Managing the factors that you can (exercise, smoking, food, alcohol) will have a positive impact on your health. The factors that you can’t change also influence your health and might make it harder to manage the diabetes.
• Think about the different ways you can monitor your health. The factors influencing your health and the changes you make can impact on different health measures differently. For example, increasing your level of activity might lower your glucose level but might not change your weight.
• Everyone is individual and everybody’s diabetes journey is different. There is no ‘one size fits all’. An eating style or medication that works for one person might not work as well or be as suitable for another person.
• Find supportive health care professionals (GPs, credentialled diabetes educators, dietitians, exercise physiologists). You might use local social media or different diabetes groups to see what health care professionals (HCPs) other people use. It might mean trying a couple of different HCPs to find the one that suits your needs.

If you would like more support or more information about managing your diabetes, please contact our Helpline on 1300 001 880 and ask to speak to one of our Diabetes Educators.