Dear Nadia:
 
I was at a restaurant. After we’d ordered, I tested and dosed. I received a hostile look from a lady at another table. I smiled and said, “I could drop my trousers and inject in my butt, if you’d prefer.” A few moments later a waiter came up and asked me to leave. On the way out I stopped at the hostile lady’s table and said, “I’ve had my hormone replacement for the evening. Enjoy your meal.”
 
I’ve grown less tolerant of the tut-tutting and behind-the-hand comments over the years.What’s your take on what I did?
 
Richard

Dear Richard:

You’ve described and asked about one of the thorniest situations that a person with diabetes can face: What is the “etiquette” for being out in public and needing to inject insulin?

I’m going to split my answer to address two specific topics your question raises.

Public Reaction

An estimated 90 million people in the US are prediabetic. In coming years, the sheer numbers of newly diagnosed people with diabetes will make public injections much more of an occurrence. Right now we are at the point where injecting yourself is a bit of a shock for some people. I would put it on a par with breastfeeding in public (which over the past 30 years has become more and more acceptable).

One part of people’s shock is the aesthetics of a an insulin injection in public. It takes some people by surprise. They’re not used to seeing bare skin under another diner’s shirt—assuming you lifted it to access a patch of skin—or a needle plunging into your skin. The woman’s reaction to your shot may have been a reflexive response to what she was seeing.

So I’m not certain that she was being intentionally rude. However, you perceived it that way and that is what you are asking about.

Dealing With and Reacting to Hostility

That woman’s hostile glare was a teachable moment. But your reaction, “I could drop my trousers and inject in my butt, if you’d prefer,” immediately shifted the blame for hostility from her to you. I understand the years of frustration and turning the other cheek that led you to say what you did, but for the restaurant workers and guests, it was over the top. The restaurant could have handled it a bitt different, if they were more educated on diabetes and medication.

Ironically, the thing you said as you left— “I’ve had my hormone replacement for the evening. Enjoy your meal.” —might have been the better initial response to the woman. Possibly she would have stood down if you had made her understand that injecting yourself in public is a necessity vital to your health. I know that’s a lot to try to convey in just a sentence or two, but it’s one way to slowly educate the general public that people with diabetes are not injecting themselves out of some sick desire to shock or repulse.

Suggestions:

I’d like to suggest three things you can do in preparation for the next time somebody gives you a hostile look. What you are most comfortable with is subjective.

First- Ignore the person. Don’t upset yourself when someone that is ignorant. If the person across from you thinks you are injecting for whatever reason they made up in their head, you cannot control that. Their reaction to you may have nothing to do with you. Just like road rage. 

Kudos for taking your injecting when you needed it. Sometimes people with diabetes will miss an injection because they are more worried about what the people around them are thinking than what they need for their medical condition.

Second, think about buying  an insulin pen. They are far more discreet because the injection needles are hidden, and the pen will not have the same social impact as a syringe. The downside to this suggestion? They are not as cheap as syringes.

Third, I think this is an opportunity for you to communicate with other people living with diabetes to compare notes about how to handle rude people when you’re injecting in public. Ask them for tips or stories about what they’ve found is the most effective way to defuse a situation like the one you were in.

Third, Yelp the restaurant that ejected you. Explain what you said and why. Be civil about it. Your statement may generate a lot of comments and perhaps even a positive response from the restaurant.  I believe the restaurant was reacting to your “butt” remark, not to you injecting in public. Use this charged experience to educate. 

When I first started dating my former husband. We went out to a nice restaurant. What impressed me the most about our date is how comfortable he was with injecting at the table. He did not care what people thought, didn’t skip a beat in our conversation while injecting. I was throughly impressed.

I get it, after years of putting up with rude or obnoxious people, this may have been an off day for you as well. My question to you is “why would you give someone that you don’t know so much power of you from a judgmental stare. Your reaction to the person indicates your own discomfort about injecting at the table. 

When I sold diabetes supplies at my medical store in San Francisco, I had one customer who said to me, that she was in love with a man but because he had diabetes she would not marry him. I shared my husband had diabetes.  She looked at me bewildered. ” You mean you knew he had diabetes and you still married him? She asked. Smiling at her ignorant question, I nodded my head and said yes.

Disclaimer:

Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professional’s therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.

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About Nadia:

Nadia was not only born into a family with diabetes but also married into one. She was propelled at a young age into “caretaker mode,” and with her knowledge of the scarcity of resources, support, and understanding for people with diabetes, co-founded Diabetes Interview, now Diabetes Health magazine.

Nadia has received 19 nominations for her work as a diabetes advocate.
 She has been featured on ABC, NBC, CBS, and other major cable networks. Her publications, medical supply business, and website have been cited, recognized and published in the San Francisco Chronicle, The Wall Street Journal, Ann Landers advice column, former Chrysler chairman Lee Iacocca, Entrepreneur magazine, Houston News, Phili.com, Brand Week, Drug Topics, and many other media outlets.

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