Diabetes etiquette.

Is that even a thing?

It sounds so formal…so well-meaning…so official.

Is there a correct way to arrange a diabetes place setting—test strips on the right, meter on the left?

Well, not exactly.

Living with type 1 diabetes in a world that doesn’t always understand it can feel isolating and awkward at times. It is a relentless condition that often doesn’t play by the rules. Even the most seasoned veteran can appear unpolished when caught off guard by something they weren’t expecting—a low, or an unforeseen spike in blood sugar…or a response by outsiders to the normal tasks that encompass all of it.

Shortly after my daughter’s diagnosis with type 1, we attended a lunch outing with a local playgroup. I was going through the motions of checking my daughter’s blood sugar while waiting for our meals to arrive when one of the other mothers began voicing her disapproval, saying she was “grossed out” by the sight of blood. Later, when I gave my daughter an insulin injection, she shuddered with repulsion as she told me how inappropriate it was that I would expect her to tolerate “invasive medical procedures” while she was eating her lunch.

“There is a time and a place for that stuff,” she said, “and it’s not here.”

Now, one could argue that a quick finger prick and minuscule amount of blood on a test strip is much less of a public health risk than kids coughing up droplet nuclei onto every surface while running amok with copiously snotty noses. I just stared at the woman, unsure of how to politely respond. In our silence, I stood on one side feeling surprised by her reaction, while she stood on the other, feeling entitled to an apology. Fortunately, my little girl had run off to the play area, blissfully unaware of the tension hanging in the air.

From lashing back to simply ignoring the comments, there are probably a million different ways to respond to these situations. On this day, I chose to walk away. We packed up, and I never went back to that playgroup again. With a 3-year-old with diabetes, a toddler, and a newborn in tow, going home was about all I could manage in that moment.

Parenting a child with type 1 diabetes inherently means that the condition will follow you whether you choose to make it public or not. For some people, it’s easier to avoid the comments by simply choosing not to share about diabetes with others. These people are often more comfortable performing care tasks in private and would rather avoid conversations surrounding it. They may find ways to keep their supplies discreetly hidden and do not want to feel that their diagnosis or their child’s is an inconvenience to others.

Then there are people who don’t mind fielding questions about diabetes and share openly when asked about it. They generally feel comfortable in a variety of situations checking blood sugar levels and administering insulin instead of seeking out a secluded area, and they don’t mind if their supplies are seen by others.

Then there are hybrids of the two…folks who perform diabetes management tasks openly in some situations—but choose not to in others. Folks who don’t mind discussing diabetes one day—but not the next. Folks who may or may not disclose their child’s diagnosis based on their mood and comfort level at the time.

So…who’s right, and what are the social etiquette rules surrounding checking blood sugar and injecting insulin in public?

Simply put: All of the approaches are right. Choosing if, when, and how much of your diabetes care to share with the world is a personal decision. We could banter valid points back and forth about each, but in the end it comes down to respecting individual autonomy.

As for the reactions of others, there’s really nothing you can do about them. You can’t control other people’s comments or expressions, but you can choose to maintain as much composure as possible under the circumstances.

You can also choose to be polite when managing diabetes tasks in public. You wouldn’t leave used tissues sitting around, so it’s probably a good idea to make every effort to clean up used test strips and juice boxes as well. It’s important to leave behind the smallest footprint possible by disposing of your trash and sharps appropriately.

You can choose to be accommodating, considerate, and empathetic to the challenges other people are dealing with too. For example, you can be willing to keep peanuts out of your child’s classroom for a fellow student with an allergy. Or choose a restaurant that can offer a gluten-free menu for a friend with celiac disease.

There may not be a steadfast rule depicting the proper way to treat diabetes in public, but there is always the Golden Rule: Treat others as you would like to be treated.

When in doubt, choose that.

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

Related topics:
My Recent Public Reprimand
People in the Know: Public Blood Sugar Checks
Why You Should Never, Ever Judge

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