Most people with diabetes – myself included – have things about their diabetes that they prefer to keep to themselves. But as a diabetes psychologist, one of the biggest challenges that I have in my practice is when I have a patient who prefers to keep their diabetes, and everything that it involves, a secret from people in their life. I’m not talking about details like their last A1c or what their blood sugar was the last time that they checked, but everything. When someone tells me that they prefer to hide diabetes from other people, it usually tells me that they aren’t taking care of themselves.
I don’t necessarily think that choosing to be secretive about having diabetes is necessarily a problem in and of itself. Everyone has the right to share, or not, anything about their health care, including what medical conditions they face. However I am a firm believer that behavior (which also includes the ‘act’ of not doing something) is functional. So when someone wants to be secretive about having diabetes, my question is ‘what function does this need for secrecy serve?’ Generally, it is one of 3 things:
- Denial: A big reason that people with diabetes don’t tell others about their diabetes is because they are having trouble accepting that they have diabetes. By keeping it a secret, it helps them keep up the belief that there’s nothing wrong. Talking about having diabetes to others makes having diabetes seem more real. Not telling others about their diabetes lets them hold out hope that it will just go away (Spoiler alert: It won’t!)
- Embarrassment: It’s really common for people to be embarrassed about having diabetes. This embarrassment usually comes from one of two places. First people may be embarrassed that they are not ‘healthy’ and feel like there is something wrong with them. Second, some people are embarrassed by the things they have to do to manage diabetes, like wear a pump, give themselves a shot, or check their blood sugar. They feel like diabetes makes them different and may have some affect on their relationships. To help them feel less embarrassed, some people keep diabetes a secret.
- Burn-out: People tend to talk to their friends and family members about things they are excited about and that are important to them. If someone is keeping their diabetes a secret, it may be a sign that they are burned out and that diabetes isn’t a priority to them at that time. This is a normal feeling. What people forget sometimes is that keeping diabetes a secret from others can make it a lot harder to get support and encouragement.
While some people find that keeping diabetes a secret may work for a time, but it also usually causes other problems. First, keeping a part of you life hidden from those around you takes a lot of work and can be exhausting. Also, keeping diabetes a secret usually means people aren’t able to manage their diabetes very well, making them feel bad physically.
Before choosing to keep diabetes a secret from others remember to ask yourself what function does keeping it a secret serve. Your answer may surprise you!