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Image: What not to say to people with diabetes

7 things not to say to someone with diabetes

Living with diabetes is difficult. Avoid making it harder with ill-informed or insensitive remarks.


By Maggie Powers, PhD, RD, CDE
July 30, 2018

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You probably know someone who has diabetes. More than 30 million Americans live with the disease. It limits their bodies from processing food into usable energy.

Diabetes is complicated. There are a lot of stereotypes and myths floating around about it. Friends, family members, co-workers or strangers can make comments that can be judgmental even if they don’t mean to be.

Remember that your words have a major impact. Choose them carefully. Said in the right way, your support can make a positive difference for someone with diabetes. But saying something that’s ill-informed can actually make living with this chronic illness even harder.

I’ve compiled a handful of the insensitive remarks that the patients I work with commonly hear from others. Check them out to learn what you should avoid saying:

  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 complex. Type 1 diabetes is an autoimmune response in a person’s body where the body’s immune system attacks itself. It’s caused by genetics and other triggering factors that have yet to be determined. Right now, there is no way to stop the onset of type 1 diabetes. The onset of type 2 diabetes is caused by genetics, lifestyle and many unknown factors. Research has shown that we can prevent or delay type 2 diabetes for some. However, there is no single cause or prevention strategy for all. So what is helpful to say? Ask how you can support them in caring for their 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. At times it can be overwhelming. The basis of a diabetes food plan is a well-balanced diet. It’s not just for people with diabetes. It’s what’s recommended for everyone. Avoid giving unsolicited advice if you’re trying to help someone meet their nutrition goals. Instead, make healthy food choices yourself and have 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. Being overweight and inactive can raise a person’s risk of developing type 2 diabetes. But, many people with type 2 diabetes are not overweight or obese. Anyone can have diabetes. Everyone with the disease needs understanding and support to do all they need to do every day.

  4. “Oh, you have to take insulin. Do you have the bad type of diabetes?”

    Diabetes affects each person differently. Some people with diabetes take pills to manage the disease. Others can manage it with diet and exercise alone. Taking insulin injections doesn’t mean a person has a more severe form of the disease. It also doesn’t reflect how well they manage their diabetes. People with type 1 diabetes need to take insulin multiple times each day because their body doesn’t produce any insulin. People with type 2 diabetes do produce insulin but the disease can change over time. That’s why their medication needs may change. Someone with type 2 diabetes might need to start taking insulin to keep their blood sugar in a healthy range. There is no good or bad type of diabetes. Everyone with diabetes has different needs. Their health care team helps them choose the best food, activity and medication for them.

  5. “I didn’t know you’re diabetic.”

    Calling someone “diabetic” labels them by their chronic illness, even if it’s said in a caring manner. 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. They are just one of many metrics monitored to provide feedback. There are many factors that affect blood sugar levels. Some of them are beyond a person’s control. Offer positive, encouraging support instead of asking someone if they did something “wrong.”

  7. “I hope you don’t get diabetes complications like my aunt.”

    People with diabetes are well aware of complications that can happen with the disease. You don’t need to highlight them. Hold off on sharing stories about complications others you know may have experienced. Health care teams and diabetes education programs help guide and support each person with diabetes. There have also been many advances in diabetes care that have reduced the rates of complications. In 2016, the U.S. Food and Drug and Administration approved the first artificial pancreas. Medtronic developed this device with the help of International Diabetes Center research. It constantly monitors blood sugar levels. It also automatically adjusts the amount of insulin delivered to the body. The device delivers more insulin when a person’s sugar level is going up. It delivers less when the sugar is headed down. That makes it a game-changer for people with type 1 diabetes and their daily challenges of controlling glucose levels.

These tips were originally published in U.S. News & World Report Aug. 16, 2016.

About Margaret (Maggie) Powers, PhD, RD, CDE

Dr. Maggie Powers is a registered dietitian and certified diabetes educator. At HealthPartners Institute, she works with nutrition leaders and others throughout the health system to promote consistent, positive, holistic approaches to nutrition care. One part of that work is providing nutrition resources to patients, employees and community members. Dr. Powers is passionate about the value of nutritional health in overall wellness. She enjoys being outside as much as possible – walking, eating, reading, camping, cross country skiing and being with friends and family, especially her grandchildren.

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