From diatribe.org
Alan Uphold, who has type 1 diabetes, shares his experiences with disclosing his diabetes to strangers, friends, and loved ones, and he offers tips for others on how to do the same
I know we don’t know each other that well yet.
But I like you, and I feel like I should tell you something.
I have diabetes.
Have you ever struggled to decide when it’s the right time to share with someone that you have diabetes?
As people living with diabetes, we are often faced with the decision about whether or not to tell someone we’ve just met that we have this serious health condition.
If you’re talking to a stranger or someone you likely won’t see again, it’s usually not a big deal. But if you’re talking to someone who is important, you might be a bit more apprehensive about revealing this information.
We make choices every day about what, when, and how to disclose information about ourselves – and not just our health.
I am a communications professor, and in my classes we talk about the process of “self-disclosure.” Self-disclosure is the act of sharing information with another person, and it is an essential component of healthy relationships.
In general, what and when we choose to self-disclose tends to follow a pattern.
Our exchange of information might be mundane at first, but as we build mutual trust and acceptance, we cautiously open up a bit more.
This process of self-disclosure is known as reciprocation, and it involves some generally accepted societal norms.
Imagine that you’re on an elevator, and a stranger steps on.
You might greet them with a casual, “Hello. How are you today?”
You don’t want a detailed account of how they are actually doing.
You’re just being polite.
Imagine if this stranger’s response is, “Well, this rain is really depressing. I had a flat tire this morning. And my doctor told me that my A1C was 8.5. So I’m having a pretty crappy day.”
Given that you just met this person, you would probably find this response unsettling if not downright awkward. In today’s vernacular, we would call this TMI (too much information).
At the opposite extreme, we can sometimes be too guarded about the information we choose to share with the people who really are important to us. Whenever we are secretive and reluctant to open up to close friends and loved ones, it can inhibit healthy relationships with them.
My friend, Steve Lapuk, a licensed marriage and family therapist with more than 15 years of experience, said that many of his clients struggle with self-disclosure.
“Whenever you disclose personal information about yourself, you are making yourself vulnerable to another person,” explained Lapuk. “If the person you disclose your information to is dismissive or judgmental, you may be reluctant to share additional information with them, and you may shut down.”
So what are the factors that we should consider before we disclose to someone that we have diabetes?
There are no set rules about how or when to disclose information about ourselves, but your decision will usually come down to two primary factors: how important is this person to you and what are the risks versus the rewards of telling them?
Lapuk suggested that you evaluate the situation, consider previous experiences you’ve had when disclosing, and think about how much risk is associated with sharing the information.
Consider a situation in which you just met a stranger sitting next to you on a plane.
If you use insulin or another medication that can put you at risk for hypoglycemia, such as a sulfonylurea (SFU), you could ask them to please wake you when the flight crew brings the meal cart around in case you fall asleep. That isn’t a very risky disclosure, right?
Your seat-mate could tell the flight crew should you happen to have low blood sugar during your flight. There’s a potential reward because sharing this information could keep you safe if you have a problem.
Another example of a new relationship might be if you start a new job.
You are going to spend at least eight hours a day with your new co-workers, so there is a potentially high reward factor if they know what to do if you have a low. Even if you feel a bit uncomfortable about sharing your health status with them, the value of telling them far outweighs the risks of not telling them.
In all of the offices where I have worked over the past 25 years, they all knew I had diabetes, and there was always juice in the break room refrigerator.
Another new relationship might be someone who could potentially become a good friend. We meet new people all the time at the gym or a bar or church. Whenever I meet someone I’d like to know better, I usually share pretty early on that I have diabetes.
The one area of self-disclosure that tends to be the most distressing is when we meet a potential new romantic interest. Do you tell them on your first date or wait a few dates?
What if you really like them, and you’re afraid that your revelation might scare them away?
What if you don’t tell them right up front, and they have a negative reaction on your first intimate moment together when they might see a pump or continuous glucose monitor (CGM) stuck to your abdomen?
If any of these fears sound familiar to you, you’re not alone.
I met my husband 25 years ago at a party, and we are still happily married.
One week after the party, we had our first date. I had only been diagnosed nine months before, and I was still trying to figure out my proper insulin dose. Keep in mind that this was well before the pump or CGMs or many of the drugs we have today.
As I arrived at the restaurant, I had the normal first date apprehensions, but I was also carrying my insulin pen with me.
In those days, disposable insulin pens were not available; they were expensive metal pens that required refillable insulin cartridges.
The pen case didn’t fit in my pocket, so I placed it on the table. I later learned that when I put the insulin pen case on the table, Jeff thought I had brought him a pen and pencil set like one that your great aunt might give you for graduation.
He was so uncomfortable that he became obsessed with it.
All he could think about for the first 15 minutes of our date was how he was going to respond when I presented him with this token gift.
When I finally told him that I needed to go to the bathroom and take my shot of insulin, he was incredibly relieved.
I later found out that at the time, he thought something along the lines of, “Oh, thank God! You’re just a diabetic – not a supernerd.”
These kinds of awkward first dates or initial dating app chats are very much part of the lives of people with diabetes.
Jen Grieves, a UK-based broadcast journalist and media producer who’s living with type 1 diabetes, has a wonderfully personal and informative website and podcast.
In a Nov. 2, 2021, interview with “Homeland” actress, Andrea Deck, describes how during her first chat with her now fiancé, David Switzer, she blurted out that she had diabetes.
Recounting the incident, Deck says, “It’s such a personal choice to make that decision to share. It’s incredibly intimate. I think if I was met with any sort of judgment or anything like that, I would have shut down immediately and stopped sharing.”
On the contrary, “The outcome just so happened to strengthen things” with David.
If you’d like to hear more about Andrea and David’s initial experiences with dating and self-disclosure, you can watch them discuss it at her YouTube channel, “She’s Diabetic.”
In my experience, letting people know that I have this condition has almost always been met with relatively little judgment or risk. Indeed, it has generally kept me safer and has helped me strengthen the relationships I have with the people I care about the most.
But my approach may not work for you. Only you can determine what is the best for you, but you can start by considering a few factors.
Evaluate the situation.
Assess how important this person is (or might become) to you.
Try to gauge how much risk would be involved by sharing that you have diabetes as opposed to how much reward you might gain.
Think about the impact your disclosure could have, not only on you, but on the other person as well.
Most importantly, remember that you are not alone in grappling with this topic. There are lots of online blogs, social media pages and resources you can turn to for help.
If you give some thought to these considerations, hopefully you won’t be quite as apprehensive the next time you’re ready to say, “I need to tell you something.”
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