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September 26, 2016
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Show and Tell, or Don't Ask/Don't Tell?

Since I missed this week's Diabetes Social Media Advocacy #dsma chat, I'm addressing this week's questions here. The topic was disclosure who (and what institutions) do you let know you have diabetes, and who (or where) do you choose to keep in the dark.


1. To disclose or not disclose: do(es) your employer/school/friends know you have diabetes? Why or why not?

The company which employs me does not know that I have diabetes; several people at work (including my supervisors) do. There is neither place nor reason to mention diabetes (or any disability) on the job application I believe it's actually illegal in the US to inquire before hiring and since hiring/firing decisions are made at the store level, accommodations must be discussed and/or made at that level, rather than the corporate level.


That said, it is important that one or more people where you work, or at your (or your child's) school, know that you have diabetes, and what that means for you (or your child). If you may have disabling lows (i.e., low enough to have to treat now, or which can affect your job performance, or which may require glucagon injection), you should disclose enough to make sure that at all times there is at least one person who will know what is going on and how to help you. (The same thing goes for highs.) This is even more important for children with diabetes who are not yet able to adjust and correct without adult supervision.


2. What situations make you feel comfortable or compelled to disclose?

I didn't disclose immediately after diagnosis. Part of this was that my office-mate had been diagnosed with type 2 diabetes some years earlier, and a number of our co-workers made up their minds that he had brought it upon himself through his weight and his eating habits. I didn't feel that my health was any of my co-workers' business, and I didn't want to put myself up to the same ridicule my co-worker faced. In addition, I was still in a sort of pro-active denial...


That said, if my disclosure can help someone, I'll disclose. If I'm running lower than I should be (or should expect to be) and need to treat, I'll disclose. If I'm eating properly and can't find something appropriate to eat, I'll disclose. And of course, I'll disclose in the course of activism and advocacy. Let's face it: it's hard to remain undisclosed when one is blogging on a major diabetes web site and wearing a Red Rider jersey when training...


3. What circumstances make you want to keep your diabetes quiet?

Certainly, I'm not happy about disclosure when it's obvious that I'd be subjected to ridicule for being diabetic. On the other hand, I don't usually stick out my hand in introduction and say "Hi, I'm Brenda, and I have type 2 diabetes."


4. Do you think all people with diabetes should disclose their health condition?

One's diabetes should probably be disclosed to someone but not necessarily to everyone. It should be disclosed where nondisclosure could pose a health risk, and preferably before one puts oneself at such risk. Which is to say that there may be no need to disclose your diabetes if you aren't taking any medications for it which will make you go low, nor if you don't follow any specific dietary restrictions because of your diabetes. On the other hand, your pump, glucometer, or CGM receiver is, itself, a disclosure.


5. How are you empowered by disclosure? Hindered by it?

Disclosure gives me the option to "play the diabetes card" when the situation require it: to choose a healthier place to eat, to get faster service (or a quick order of orange juice) if I (or The Other Half) needs it, and to help others when the need occurs. On the other hand, I think there are some social opportunities which are not presented to those of us with diabetes because "they're serving [something the inviters believe we shouldn't consume]" or "there'll be nothing there for [a PWD] to eat", or because people are afraid of legal or health liabilities if we should go low or high during the course of the event, or because of the food and beverages served at the event, or because the event takes place somewhere that medical assistance is not readily available.


6. What advice do you have for the people being disclosed TO?

First, remember the person who has disclosed his or her health condition to you is a person, and is entitled to the same courtesies and considerations you would give any other person. Second, you were entrusted with this information because the person who has disclosed to you trusts that it will not be misused, and that it will be used to help him or her if and/or when a situation related to this health information occurs. (In the case of diabetes, this might mean a sudden, severe, or untreated high or low, a need to test, or issues with insulin or other diabetes medications, or issues related to complications of diabetes.)

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