It’s Time to Reframe the Conversation Around Diabetes Complications


Whether you have been recently diagnosed with type 2 diabetes (T2D) or have been managing it for a long time, you may be concerned about diabetes-related complications. They are common—half of all people with diabetes will experience some diabetes-related complication.

Despite this fact, there’s a lot of stigma around diabetes complications, and it hurts everyone living with or affected by T2D. It’s time to reframe the conversation around living with diabetes complications, so we are breaking down what you should know so you can be an advocate for your diabetes health.

What are the complications of diabetes?

Diabetes touches every part of the human body, and people who live with the condition may experience long-term complications. These include:

  • Blood vessel damage affecting the eyes (retinopathy), which may lead to blindness
  • Lower limb amputation, most often involving toes and feet
  • Kidney disease
  • Heart disease
  • Stroke
  • Nerve damage (neuropathy)
  • Depression and anxiety
  • Receding gums and other oral health issues

There are also short-term complications of diabetes. Diabetic coma from severe low blood sugar levels and diabetic ketoacidosis (DKA) from high blood sugar levels can both come on suddenly and may require urgent medical attention.

How does diabetes cause complications?

Diabetes touches nearly every part of your body. When blood sugars are consistently high over long periods of time, it can damage nerves, blood vessels and organs.

The longer you have diabetes, the more likely you are to experience complications.

Complications are not inevitable. They are, also, not always preventable. Remember, diabetes affects every person’s body uniquely and there are many factors that impact day-to-day diabetes management. If you face complications, you aren’t to blame.

Stigma and shame negatively affect health and medicinal care

Studies show that the stigma and shame around diabetes complications negatively affect people’s health and the medical care they receive.

Patients report that stigma towards their condition leaves them feeling embarrassed, fearful, guilty and full of anxiety. Patients who are stigmatized also report lower self-esteem.

Diabetes stigma is increasingly viewed as a social determinant of health, meaning stigma is a non-medical factor that has a measurable impact on health outcomes. People with diabetes who are stigmatized are less likely to stick to their diabetes medication regimen, which may increase their risk of complications.

Diabetes complications stigma affects providers as well

Providers and doctors are not immune to reinforcing stigma around T2D and complications, either. The stigma and stereotypes surrounding obesity and T2D overlap, and weight bias in healthcare settings is well documented, unfortunately.

Weight bias can have a significant impact on how healthcare providers interact with their patients. Data shows that providers spend less time in appointments with individuals who are obese, focus less on building rapport and relationships through conversation and view them as less likely to stick to their prescribed medications.

Furthermore, stigmatized individuals are more likely to avoid doctors and healthcare settings,  engage in disordered or unhealthy eating habits and avoid exercise and physical activity.

This all goes to show just how damaging stigma can be and that we all have a role in fighting the bias and stereotypes that affect people with T2D.

Know you’re not alone

If you are experiencing complications of diabetes, you’re not alone! Half of all people with diabetes will experience nerve damage.

You may feel shame, fear, and anxiety about suffering complications as a result of diabetes. The bottom line is that suffering from complications does not mean you’re lazy, or that you’re not taking good enough care of yourself.

If you live with diabetes, you know there’s no perfect formula for managing blood sugar. So many things affect your diabetes.

Don’t blame yourself

Whether you have brittle diabetes, or just deal with persistent highs, you may be frustrated with your blood sugar levels despite your best efforts. The time and money it takes may also be a barrier to sticking to your diabetes management plan, especially if you are uninsured or underinsured.

You may feel a sense of failure or defeat if you’ve been diagnosed with a diabetes-related complication. It is crucial not to blame yourself or let those feelings snowball.

Below are some ways to fight the stigma you face about complications of diabetes.

Empower yourself with knowledge

Educate yourself and the people around you on the facts and figures about diabetes. This goes a long way towards dispelling the myths surrounding complications and those who live with them.

Be an outspoken advocate for your needs

Many complications of diabetes are invisible, which may only feed into the stigma. You may hear things such as, “You don’t look sick!” or, “It can’t be that bad!”

Share what you’re feeling, or what activities may be more difficult for you. Don’t hesitate to request special accommodations you may need to work, go to school or access healthcare.

Sharing your experience with diabetes with friends, family, colleagues, or even lawmakers can help them understand your diabetes better and support you and advocate for your needs.

Get loud about our struggles

Here’s where we get loud. We need to break the stereotype of the “typical person” who experiences diabetes complications. This is how change is made.

We do this by making our voices heard, being seen, speaking our truth, and showing up when it counts. Break the stereotype for those who come after us.

Seek peer support

Joining a community with others living with diabetes can be a huge boost to morale.

Whether you connect with people online or find an in-person support group, being in a community with others who truly understand what you’re going through is key to feeling less alone.

How to support someone with diabetes complications

We ALL play a part in destigmatizing complications. If someone you know has recently been diagnosed with a complication and you want to help, let them know you are there to support them without judgment.

If you hear them criticizing or blaming themself, share what you know about diabetes complications to dispel the stigma that leads to shame and self-blame.

Be cognizant of how overwhelmed the person may be feeling, and when possible, offer tangible ways to help them care for their diabetes and emotional health. This could be as small as a ride to the grocery store or an invitation to exercise together.

Ask questions about how they’re feeling and what kind of support they need, if any. Let them know it’s okay to be vulnerable.

Remember, anyone can play an active role in fighting the stigma around diabetes complications.

Editor’s note: Educational content related to complications of T2D is made possible with support from Lilly, an active partner of Beyond Type 2 at the time of publication. Editorial control rests solely on Beyond Type 2.

WRITTEN BY Christine Fallabel, POSTED 12/22/22, UPDATED 12/22/22

Christine Fallabel has been living with type 1 diabetes since 2000. She's a health and science writer and has been featured in Diabetes Daily Grind, diaTribe, Insulin Nation and Diabetics Doing Things, and is a regular contributor to Diabetes Strong and Healthline. She earned her Master of Public Health from Temple University. In her spare time, she enjoys hiking with her husband in the mountains of Colorado, tinkering with her DIY Loop insulin pump, coffee and reading in front of a cozy fire.