A Type 2 Diabetes Diagnosis: Overcoming Shame and Stigma
Jan 7, 2020, 12:02 PM
by Veronica Brady, MSN, APRN, NP, RN, BC-ADM, CDE
This is it; you are starting the new year with fresh eyes and a desire to be the best practitioner you can be. The first client of the day/week is all ready for you and even comes with lab work in hand.
D.K. is a 47-year-old African American female that you are seeing for the first time. You review her chart before entering the room and note the following: BMI - 29, BP - 117/72, A1C - 7.5%, HDL- 38.
You have already determined that she has type 2 diabetes, and it is your job to address it.
You enter the room and there she sits — looking a bit fearful and somewhat ashamed. You begin to talk about the diagnosis of diabetes, but she stops you and says, “Do you think it could be type 1 diabetes and not type 2?” You pause and ask, “Why would you want it to be type 1 diabetes?” She replies, “If it is type 1 then people won’t think that it’s all my fault.” This statement gives you pause. You sit up a little straighter and tell her, “Let me get some additional information and we will come back to this question.”
As you continue the interview, you note that D.K. is very active and she has never been overweight. Her mother and grandmother both have type 2 diabetes and she has previously been diagnosed with polycystic ovary syndrome (PCOS).
It is at this point that you decide to take the time to discuss with her the risk factors for type 2 diabetes which include:
- Overweight or obese
- Over age 45
- High blood pressure
- Low amounts of good cholesterol (HDL)
- First-degree relative with diabetes
- Physical inactivity/sedentary lifestyle
- African American, Pacific Islander, Hispanic/Latino, American Indian and Alaska Native ancestry
- Polycystic ovary syndrome (PCOS)
You then explain to her, that although she does indeed have type 2 diabetes there are some things that she has no control over:
- Age
- Family members
- Ethnicity
By the end of your discussion, D.K. thanks you for making her feel less guilty about her diagnosis.
As a provider, we often assume that clients develop type 2 diabetes as a result of a lack of exercise and poor eating habits. This is not always the case. We need to take a step back and truly evaluate the person sitting in front of us. We need to be careful not to come across as judgmental when making the diagnosis of type 2 diabetes or in providing care. Oftentimes they feel bad enough without us layering on the guilt.
For more guidance on what you can do to empower your clients using language, visit DiabetesEducator.org/language.
AADE Perspectives on Diabetes Care
The American Association of Diabetes Educators Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the American Association of Diabetes Educators.
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