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Talking To People About Your Diabetes And Diet

Talking about your diabetes can be a powerful way to advocate for your health.

with Janet Zappe RN, MS, CDE

Two women dressed in hijab talk over coffee at a cafeSharing how you make healthy choices for your diabetes can help others better support your needs.

Living with a chronic health condition means making lifestyle adjustments in a variety of ways. When it comes to living with diabetes, self-advocacy is key — whether that means explaining what insulin is to curious people or passing on that extra round of drinks or dessert. 

What is diabetes?

Diabetes is a chronic disease that impacts the way your body regulates glucose, or blood sugar. Glucose comes from the foods you eat and is your body’s fuel source. When you eat, glucose enters your cells to give you energy — and in order to do so, the hormone insulin is required. Think of this all-important hormone as the key to get through the doorway. 

Insulin is made in the pancreas, and it controls how much glucose enters your bloodstream. It also helps regulate the metabolism of your macros — carbs, proteins, and fats — and it helps to store glucose as well. 

There are two main types of diabetes: 

  • Type 1 diabetes. Your pancreas doesn’t produce insulin — at all. This is often also referred to as Juvenile Diabetes, since it generally is diagnosed in childhood. Living with type 1 diabetes means closely monitoring your blood sugar and taking insulin through injection with a pump, pen, or syringe.
  • Type 2 diabetes. Your pancreas likely doesn’t make enough insulin, and your body doesn't respond well to it, anyway. Type 2 diabetes is more common than type 1 diabetes, and it often occurs after the age of 40. 

When you can’t make enough or any insulin, your blood sugar can skyrocket — and this can lead to myriad health issues, including (but not limited to):

  • neuropathy (nerve damage)
  • retinopathy (retinal damage)
  • cardiovascular problems
  • depression
  • skin issues

Talking to friends & family about your diabetes

Whether you’ve been recently diagnosed or are informing people in your life, you may want to explain to others that you have diabetes and that it's really important for you to: 

  • manage your blood sugar levels
  • watch your insulin intake
  • adhere to a dietary and exercise regimen

Sometimes, it’s hard for people to understand because they aren’t sure how diabetes works. 

Advocating for yourself is especially necessary when it comes to social situations where food and alcohol are involved. 

Preparing to eat a meal with others might mean: 

  • making different food choices or requests
  • adjusting your medication
  • asking to eat dinner at a certain time

If you are newly diagnosed or trying to better manage your diabetes, it’s helpful to let other people know that your dietary needs may have changed — especially if you’re often eating at work or at social gatherings. 

Ask for what you need, offers Nancy Sayles Kaneshiro, co-author of Weighty Issues: Getting the Skinny on Weight Loss Surgery, and 21 Things You Need to Know about Diabetes and Weight Loss Surgery, published by the American Diabetes Association.

“Be straight with your family and friends,” she says. “That will ease the transition into diabetic-friendly diet changes. I remember many conversations that began with, ‘No, I really can’t go out for pizza (or pasta, or other high-carb favorites).”

Many people with diabetes try to eat specific, healthy foods, or in accordance with the Diabetes Plate method, which involves filling half of a nine-inch plate with non-starchy veggies, another quarter of the plate with protein, and the last quarter with carbs. But this can be hard to do when you’re having dinner with friends or at a work event. 

Here are some suggestions to support better nutrition habits: 

Try to keep a regular eating schedule

First, eating at about the same time each day helps keep your blood sugar steady, especially if you’re taking insulin or medication. If you’re going out on the town, let everyone know why you’d like to eat at a certain time, and try to make a reservation around the time you typically would eat. If dinner runs late, have a small snack beforehand. 

When you’re eating out, check the menu beforehand

“My little trick is to check menus online before getting to a restaurant so that I’ve already made my healthy choices! That avoids any arguments or embarrassment,” says Kaneshiro.

This can help prevent you from feeling rushed and making a hurried choice when everyone is ready to order. Check if they offer substitutions for certain meals. You’ll also want to check on portion sizes, which can sometimes be substantially bigger than you’re used to making at home.

Sometimes, though, eating dinner out can be a challenge even with proper planning. 

According to Renee Rayles, who was diagnosed at 45 with Type 1 latent autoimmune diabetes in adults (LATA), “For me, going out to eat has been the most challenging. Even if you can plan, things go awry. For example — maybe there's no nutritional information and you have to wing it. Or nutritional information doesn’t seem accurate to the actual food that was served,” Rayles says. 

This led to her overdosing or underdosing insulin, a problem she says was improved by eating a lower carb diet. 

When eating at someone else’s home, speak up for your needs

If you are going to someone’s home for dinner, there’s no shame in politely letting your hosts know that you have some dietary restrictions. For example, if you know that you’re going to be chowing down on pasta, you can request a whole wheat pasta option be served. Most people are very understanding when it comes to dietary requirements for health purposes. 

Talk to your partner about your changing dietary needs

“[After being diagnosed with LATA Type 1], we have overall stuck to a lower carb diet. That is around 20 grams of carbs per meal. Keeping it in that range has been great for keeping my blood sugar in a good range.” 

Rayles said it was very important to explain her changing diet to her husband. “Knowing how serious type 1 diabetes is, I spoke to my husband about the seriousness of hypoglycemia and hyperglycemia. His response was, ‘What do we need to do?’”

She says that she explained her dietary needs, her daily medicinal requirements, and all of the signs and symptoms he should watch out for (like confusion or sweating in diabetic hypoglycemia).  

Know the relationship between alcohol and diabetes

Happy hour can be a bit tricky if you have diabetes. Moderate drinking — which amounts to five ounces of wine or a 12-ounce beer per day, for example — has been shown to offer some health benefits. Any more and the science isn’t so sure — and that’s especially the case for diabetics. It all depends on what you’re drinking, how many carbs a drink contains, and how much you’re drinking. In short, it’s very individual. 

Drinking alcohol while taking diabetes medication, including insulin, can lead to hypoglycemia, which is an extreme dip in blood sugar. To make matters more complicated, hypoglycemia symptoms — like slurring and confusion — may mimic being drunk. 

If you are imbibing, don’t do it on an empty stomach — and make sure you don’t drink too much. 

For David Kendrick, who was diagnosed with prediabetes and made lifestyle changes to prevent type 2 diabetes, drinking alcohol was too risky because it led to other bad behaviors. “When I drink, I crave food high in sugar: candy, cereal, chocolate,” he says. “When I was told how much sugar is in alcohol, I was shocked.” This is especially true for sweet wines and alcoholic drinks mixed with sodas and juices. 

If you’re at the local pub or a work happy hour, you have options:

  • Stick to a well-chosen drink or two.
  • Explain to coworkers or friends that alcohol and diabetes don’t always mix.
  • Make friends with the bartender. Let them know you’re not looking for alcohol, and they’ll pour you sparkling water or a drink diluted by club soda. You can always ask about a drink’s ingredients, too. 

Disclosing your diabetes 

Another way to communicate that you have diabetes is to wear a medical alert ID or carry a card, which can tell other people that you have a risk of hypoglycemia or may need help. 

Additionally, it may be helpful to let your employer know that you have diabetes so that they can’t discriminate against you for needing days off or requiring special arrangements. This is due to the Americans with Disabilities Act

Talking about your experience with diabetes is very personal

Speaking up about your diabetes is entirely your choice. It can be a powerful way to embrace your experience, and to advocate for yourself along the way. Your diagnosis is nothing to be ashamed of. 

For some people who have diabetes, speaking openly about it is harder. There are unfair stigmas attached to diabetes, all of which are all reductive and harmful ideas. 

Which is why some believe it’s important to let people know. 

According to Natalie K., 36, having diabetes, felt like something she needed to keep secret at first. “I used to hide what I needed to do — like run into a bathroom to inject insulin,” she says. “But I have learned that letting people know what you need to do for your health makes management so much easier. I eventually realized that was unsustainable and started to let my friends know what I need to do for my health.”

Janet Zappe RN, MS, CDE, of the Ohio State University Wexner Medical Center's Diabetes and Metabolism Research Center offers, “I tell the person with diabetes it’s up to them who they tell. Family should be supportive ideally. The sooner they accept the diagnosis, the sooner they can be healthy and face the challenge. Diabetes can be tough, but they are tougher than the diabetes.”

In the end, explaining what your insulin pump is, requesting a different menu option, or saying no to a night out are all ways you care for yourself. 

“I am very clear about what I need to do to stay healthy and no longer ask for permission,” Natalie says. “I state everything about my health needs as a factual statement. Everyone has something they need to manage — health or otherwise — so managing diabetes just happens to be what I have to monitor. My health needs have to come first or nothing else works.”

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