What Does a Diabetic Look Like?

“Wow … you don’t LOOK like a diabetic!” I hear that comment frequently and always have to stop and wonder, “What the heck does a diabetic look like?” I know the statement is intended to be a compliment, and it’s one I appreciate, but I confess the comment offends me. There, I said it. Being told I don’t “look like a diabetic” offends the heck out of me. Why does it offend me? Because it implies that people with diabetes are sick and look ill, can’t function normally, and should look like invalids or be morbidly obese. Nothing could be further from the truth!

question marksI’ve had Type 1 diabetes for over 45 years. Yep. Almost half a century. In spite of that, I travel frequently,
ride my motorcycle everywhere (as the rider, never a passenger), keep a crazy schedule, eat out without concern, live life to the fullest, and prefer to say I have diabetes instead of referring to myself as a diabetic. (The difference in perspective is huge.) Diabetes has NEVER stopped me from doing anything, and it never will. Well, ok … I confess having diabetes could have once stopped me from parasailing, but I lied about it. (God forgave me.) There are laws that say I can’t get a commercial driver’s license, fly a plane or scuba dive, but I can damn well do everything else. Having diabetes means I have to plan ahead. It doesn’t mean I have to give up.

Although I have Type 1 diabetes (the type that is controlled using insulin), most people in the US have Type 2 diabetes. Type 2 diabetes is caused when the cells in the body cannot utilize the insulin being produced. Blood sugars rise as a result. Type 2 diabetes is often referred to as “insulin resistance” and is typically controlled using diet, exercise, supplements and/or oral medication if needed. The nice thing about Type 2 diabetes is that it can often (not always) be reversed if the person is willing to make the necessary lifestyle changes. Some things discussed in this post are more applicable to people with Type 1 diabetes, some are more applicable to people with Type 2.

Regardless of which type of diabetes we are blessed to have, people’s perception of us changes the instant they hear we have “it.” The fact that I have diabetes is such a minor part of my life that I rarely share that I have it. If it comes up, I can immediately see people’s perception of me change. Their gaze fills with pity, their forehead wrinkles as they wonder why I look so healthy, and they immediately check my plate to make sure I’m eating as they think I should. The judgments and assumptions drawn are often incorrect and always unfair.

Let me state this very clearly: I am a Type 1 diabetic. I am what some doctors refer to as a “brittle diabetic,” meaning my blood glucose levels often change unexpectedly. In spite of that, I maintain superior control. My blood sugars run between 85-100 at almost all times and my A1C percentages (a three-month average of blood sugar levels) are consistently under 6.0. Normal is 4.5-6.0. It takes a lot of effort to maintain normal blood sugars with diabetes, but I seamlessly weave those efforts into my daily life. The fact that I regard diabetes as a “minor” part of my life doesn’t mean I ignore it, it simply means I’ve chosen to control it instead of letting it control me. It also means I don’t regard it as the main part of my life. My life is filled with too many wonderful things to ever consider diabetes to be one of the main ones.

Based on what I see in the media (I’ve been known to throw things at the TV during commercials for diabetes products) and hear from people unfamiliar with diabetes, here’s what I suspect a diabetic is “supposed” to look like:

  • Diabetics have syringes for arms & legs, a pill bottle for a head, and one leg in the grave: Most people with diabetes participate in sports, work full-time, have active social lives and go through pregnancy and raise children with relatively few problems. The fact that I have diabetes doesn’t mean my life is controlled by it. I have challenges and have to consider things others don’t, but I control it, it doesn’t control me. Period. I don’t find my identity in my disease. My identity is in who I am as a person and has nothing to do with the fact I have diabetes.
  • Diabetics are all fat: Diabetes has become such a common disorder that it no longer has a “standard” demographic. People with diabetes come in all shapes and sizes. Some are rail thin, some are grossly obese, and most of us fall somewhere in the broad range between the two. Not all fat people have diabetes, and not everyone with
    diabetes is fat. Please let go of that stereotype and move on.
  • Diabetics spontaneously combust if they eat sugar: The myth that diabetics can never eat sugar is just that, a myth. People with diabetes obviously need to make careful choices when it comes to food, but an occasional indulgence is not going to kill us. Frequent indulgences may, but please don’t freak out or give us a disapproving look if we eat a cookie in front of you, ok? We’re smart enough to know what we can and cannot eat. People with Type 1 diabetes take extra insulin to counteract the effect an indulgence has on their blood sugar. People with Type 2 diabetes hopefully exercise or use other methods to counteract dietary indulgences. I don’t mean to imply that people with diabetes can eat like pigs. (Or like most people in the US eat.) People who have diabetes and eat whatever they want with no regard for how it affects their blood sugar typically suffer higher rates of diabetic complications, such as blindness, amputation, heart disease, etc. However, eating a single Twinkie won’t cause us to spontaneously combust. I promise.
  • Diabetics are weak invalids who have a lot in common with Eeyore: Most people with diabetes lead full, vibrant lives. They do if they choose to, at least. They have challenges, but their efforts to control diabetes are tiny threads easily woven into the fabric of their lives. Yes, it is true that diabetes has the capacity to kill us if we don’t control it, but many people with diabetes who have not suffered horrible side effects are invalids because they chose to be. Sometimes it happens due to fear, but it often happens because a medical professional at some point convinced them they had a serious illness that would destroy their quality of life. You wouldn’t believe how many of my patients with diabetes have told me the doctor who diagnosed them told them they had diabetes, their condition would continually deteriorate, and that they would eventually die a horrid death from it. Instead of telling them they had diabetes and that their condition could be controlled (or even reversed in some cases), their doctor sucked the hope right out of them and then sent them home to die. It’s criminal, but it happens more frequently than people realize. The truth is that there is no reason people with diabetes need to let diabetes interfere with leading a full, vibrant life. None. I know my last paragraph made some of you angry. Please know I don’t mean to imply diabetes is not a serious disease that is ruining lives. It is. Some people experience horrible side effects in spite of maintaining excellent control. Diabetes isn’t fair. Period.

There you have it. Apparently that’s what a diabetic is supposed to look like. I guess I can only thank God that people are surprised I don’t look like that. When I see someone’s forehead crease with concern and their eyes glaze with pity, I usually smile and walk away. The people I adore are the ones who acknowledge I have diabetes but who form an opinion of me based on who I am, not on what I have. They are the friends who hand me a bottle of juice when they know my blood sugar is low, but who don’t assume it’s low everytime I trip or can’t find the right word to finish a sentence. They ask before assuming. I love them. Dearly.

By IndyHealer

Pamela Reilly is a Naturopathic Nutritionist with a burning passion for helping others achieve wellness using an integrative approach combining mainstream medicine with natural modalities. She has over 20 years of experience in natural medicine, has multiple certifications, and is currently completing a doctorate in Naturopathic Medicine. She is part of the practice of The Logan Institute for Health & Wellness in Fishers, Indiana. She is available for consultations in person or over the phone and can be reached at 317.598.4325.

10 replies on “What Does a Diabetic Look Like?”

Hi, Cherri. The meaning of “grossly” is extremely. This term was not used the way “gross” is commonly used. The phrase simply means “extremely obese,” not “disgustingly obese.” Please know I used to be grossly obese and would never use a term that was derogatory. I apologize I used a term that was misunderstood. Thanks!

Thank you very much for this. My boyfriend is a Type 1 diabetic who has in the past had pretty shitty control of his sugars. It has been a steep learning curve, but he does a lot better lately, and it’s always nice to hear other people who understand what this disease is like.

“Having diabetes means I have to plan ahead. It doesn’t mean I have to give up.” This is it, exactly.

I really appreciate this perspective. I have only known a few people with diabetes and all of them have led happy, productive, thriving lives. In fact, one or two with Type 2 Diabetes have made profound lifestyle changes–these changes led to better lives for them and their families, too. A good friend of mine said he wasn’t happy until his doctor diagnosed him with diabetes and forced him to change how he’d been living.

I don’t think that’s representative of everyone’s experience, of course, nor do I think its representative of the disease as a whole. But I do think that perspectives like your own are so needed these days.


Not all fat people have diabetes, and not everyone with
diabetes is fat. Please let go of that stereotype and move on.

Exactly. I am overweight and I went to the doctor recently for a rash. He barely spent a moment looking at it–didn’t even touch it!–before he said, “Are you diabetic or hyptertensive? You should be checked.” I’m not diabetic or hypertensive and no matter what I said, he refused to treat the rash because he didn’t see a skin condition, he saw a fat person. I hate this stereotype.

Thanks for such a well-argued article and for sharing your successes with your disease. More people need to hear these stories!

Hi, Kortney. Wow … I am so sorry you experienced that form of prejudice and malpractice! Experiences like that are what led me to pursue becoming a Naturopathic Doctor instead of an MD, although I’m considering going to med school so that I can create change from the inside! I hope you fired that doc and found one who would treat what needed treating instead of making wrong assumptions.

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