{Diabetes} Miss Manners Misses the Mark

by Leighann on February 19, 2014

My daughter was diagnosed with type 1 diabetes at the age of three. She doesn’t really remember life without it.

We made a conscious decision that, because it was a big part of who she is and because she would have to live with and manage her diabetes for the entirety of her life, that we would not hide her diabetes management.

Now I’m not saying that we shout from the rooftops “Look over here! We’re about to check her blood sugar! Look, blood! Look, a syringe!”

But we also felt that if it was no big deal to check blood sugars and give injections, then perhaps checking blood sugars and getting injections wouldn’t be such a big deal.

We do diabetes management wherever we are, whenever we are.

Of course sometimes we need to check on a pump site or CGM sensor that’s in a place that we don’t want to bear in public.

Do we get questions?

Yeah, sometimes.

But it can be an educational or advocacy moment.

When asked what she’s doing or if she has noticed someone watching, Q may respond with a quick explanation such as “I have type 1 diabetes. I have to check my blood sugar.”

I’ve found that kids are just curious. Most of the time they just say “Oh, okay” and it’s back to whatever they are doing.

We have never had an adult say something rude to us or ask us to please do it somewhere else. But honestly if that ever happened, I’m sure I would either ignore them and continue or I would say “grow up.”

It has always been my philosophy that something only becomes a big deal if you make it a big deal.

Asking my child to hide her diabetes implies that she should feel ashamed.

Millions of people living in the United States have diabetes, whether type 1 or type 2. No matter the type, it is a chronic medical condition that requires vigilance and monitoring.

So it’s quite dismaying to see that a so-called etiquette expert says that someone on an airplane should go to the lavatory when drawing blood or using a syringe.

Have you been in an airplane lavatory?!


Not to mention that there’s barely enough space to do your business.

And could you imagine trying to check a child’s blood sugar or give an injection with the two of you wedged in there?

I can just picture thousands of dollars of medical equipment accidentally dropping into the blue toilet water!

So here’s my advice: do what you’ve gotta do, when you’ve gotta do it, where you’ve gotta do it.

You have my permission and blessing.

What do you think of her advice?

From Miss Manners:

“Absent an emergency, medical applications (like bodily functions and grooming) are properly done out of sight — meaning in private or in a restroom — unless they can be done so surreptitiously as to be unrecognizable as such.”

(And as a side note, I thought her comment about children was condescending: “You may chose to tell children that it is a medical procedure, or ignore them and let their parents do that. Miss Manners would hope that any parents present would also resolve to teach their children to be more discreet with their curiosity.”)

{ 32 comments… read them below or add one }

1 Lynn February 19, 2014 at 10:10 pm

I am a mom of a T1D, recently turned five. She received her diagnosis 6 months ago, so we are new to the game here. With that said, I can not say that I do not see both sides of this topic. Prior to my daughter dx I was a person who suffered from extreme phobias of both blood and injections. I have been that way my whole life and it was a mental challenge to get past that for the sake of my daughter. Therefore, I can not be a hypocrite and say tough luck to people out there, like I was, just because my daughter now has a condition. I take extreme measures and preperation to try and avoid taking her readings where people are subject to see, especially kids. It would have to be a case of a real emergency for me to do otherwise. I would never take her into a bathroom, but I will look for an out of the way spot, or take her to our car, our attempt to shield the process when we are out and about. When we took a two hour plane flight, I took her reading at a gate where there was no one there 10 min before the flight and, in the absence of an emergency, I had zero intentions on taking it again during the flight. Whether right, wrong or indifferent, I try to be mindful of the fact that there are people out there like I was and probably still am to some degree.


2 Jennifer February 19, 2014 at 10:13 pm

I had a parent, who was hosting her child’s birthday party, ask us to go into the bathroom to check my child’s blood sugar & give her insulin because it may upset the other children. This mom is also an RN.


3 Teri Law February 20, 2014 at 11:34 am

As a diabetic who does not hide when checking blood sugars or taking insulin, I happen to agree with the host in this case. It is never my intention to upset children for any reason and yes, children are fearful of shots and needles. In a room full of young children, going some place else is probably the best course of action.


4 Jennifer February 21, 2014 at 5:57 pm

Yes, that is what I did, but it did make my daughter feel bad. These girls were older too…at 12 or 13.


5 Jennifer February 21, 2014 at 5:59 pm

And kids in her school see her check her sugar in class and get her insulin shots in the clinic. We’ve never had any issues there, just curious questions.


6 Jennifer February 21, 2014 at 6:08 pm

Guess I should also give my daughter’s age. At the time of the party, she was 9. There was 1 toddler, 1 baby and the rest of the girls were her age or older. My daughter is now 10.

7 Jennifer February 21, 2014 at 5:54 pm

Hi, I wrote the above comment. In this particular situation, we were at the birthday girl’s parent’s house. There were not many kids, mostly their family, and I was the only parent who stayed. My husband and I have also always taught our daughter to never feel embarrassed or ashamed to check her blood sugar or give insulin in public. Needless to say, I was completely taken off guard when the mother saw me checking my daughter’s blood sugar, and asked for us to please go into the bathroom if we were to check again or give insulin. She was worried about how her nieces would react. Prior to this, we were actually having a good discussion about my daughter’s diabetes and what we do to manage it. I really felt like the mother understood, because she was an RN and because her husband had recently been diagnosed with celiac disease. Her daughter, the birthday girl, was actually in my daughter’s class, and had accompanied her on numerous occasions to the clinic to check blood sugars, and when nurse gave her her insulin. I did take her in the bathroom to give her insulin, but I felt very uncomfortable the rest of party. I was just wondering how any of you would have handled the same situation? I really didn’t know what to do because we were a guest in their house, and I didn’t want to embarrass my daughter in front of her friends by just leaving the party.


8 tmana February 19, 2014 at 10:15 pm

I understand Miss Manners from the position of somebody not having to live with diabetes, finding the view of it uncomfortable. That said, given projections that by 2050, 1/3 of the population will have it — isn’t it about time that etiquette evolved so that a tacit understanding of medical needs would allow *social* privacy without requiring *physical* privacy? Or that a general understanding of diabetes care should be required of the general population?


9 Heidi February 20, 2014 at 7:48 am



10 Alyson Cheatham February 19, 2014 at 11:28 pm

I am with you, when at restaurants I will dose my T1 20 month old son at the table right before his food arrives. I don’t care who is uncomfortable with it. It’s amazing how as a society, we are so forgiving of other grievances, but when we have to pull a little bit of life out of a glass vial for our child people get scared because there is blood. Get a grip America, I would much rather see someone dosing their child with insulin, the watch some people eat these days. Perhaps Miss Manners could touch on that and write an article on how adults should chew with their mouth closed. It’s a travesty, that this has become such an issue, and I am that parent who when on a plane in December 2013 did check my son’s blood and give him a shot of insulin mid flight, right in our seats. Maybe she wrote the article about me. 😉 I applaud you for writing this post and would love to share it on my blog site if I may, http://www.thediabeticjournal.org. Great job and us Diabetes Mom’s gotta stick together and educate those around us!


11 Leighann February 20, 2014 at 7:17 am

I always appreciate when people share links to my posts so their readers can click over to my website. Please let me know if you do link to me. Thanks for leaving a comment!


12 Sara Jensen February 19, 2014 at 11:30 pm

I was horrified by the post. Even before diagnosis I would have never expected someone else to go to the bathroom to take care of themselves, much less a child. I recently had someone a plane tell me to not talk to my husband across the aisle about my son’s reading on his Dexcom (CGM). Just a number, it wasnt my proudest moment but after she continued with talking about my son’s “gross medical whatever” I made it a point to give him his levemir right in front of her face. I refuse to let someone shame me into squishing into a gross dirty tiny bathroom to take care of my child.
In fact I am designing cards for my son to hand out that have a short explanation of T1 and the other sides say different things like “here is some information about T1”, or “wow, you are rude!” or “lets have a playdate, its not too scary”.


13 Teri Law February 20, 2014 at 11:36 am

Fabulous response. The woman on the plane was out of line. I love the ideas of the cards.


14 Jennifer Kelley February 20, 2014 at 5:40 am

We are quickly approaching my daughter’s 5th anniversary of diagnosis and I am just going to say that Miss Manners is wrong, wrong, wrong. In the past five years, J (who is now 19) has done fingerpricks, shots, and pod changes all in public view. In fact, her youth group friends think it’s a novelty to watch those things and get excited when they are on the mission trip and it’s time to change the pod! Her little person she babysits likes to help, too!! As to others who are icked out by it, turn your head. Geesh!!


15 Lina February 20, 2014 at 6:04 am

I think this is relative to people complaning about what’s on t.v or the radio.. which we should then say to complainers of what diabetics do in public: If you don’t like it or if it makes you queasy because you have a blood phobia, then look away!


16 Jennifer February 20, 2014 at 6:06 am

My son was diagnosed with T1D just before his 3rd birthday. I have 2 younger children. I do not drag him away to test & cover. Now that he is 11 I am more sensitive to his willingness to show me his infusion site in public. I certainly would not drag all 3 kids into the bathroom for a blood sugar check! When my son was diagnosed his preschool teacher explained his needs to the classroom by saying “I need glasses because my eyes don’t work as well as yours. He needs insulin & blood sugar check because his body doesn’t make insulin like yours & mine.” The kids all shrugged & moved on. We all have differences & needs that may not be apparent to those around us. Shame on Miss Manners for suggesting we should hide them! What if that gentleman was having a low blood sugar & passed out in the bathroom or stumbled & hurt himself trying to get to the bathroom. It is not always about the people around you & their comfort…sometimes it is about your health & well being! Next time you respond, Miss Manners, make sure you understand the diagnosis & the potential ramifications of your response!


17 Heidi February 20, 2014 at 7:51 am

So true!!!


18 Need A Nap2 February 21, 2014 at 1:56 pm

I agree, there’s no way I would drag all 4 of my children into the bathroom! When my daughter was diagnosed she was 7, but her sisters and brother were 5, 3, and 1. (That was 5 years ago.) I was diagnosed in 2012, it was one thing to expect my daughter not to hide but now I serve as an example and advocate for her. I consider other people looking as an educational moment. If I’m in public (like a Bible study), I try to warn others to look away if they have issues. 🙂


19 Naijabetic Mama February 20, 2014 at 6:38 am

When in a restaurant, I tell my 12 yr old son to go to the restroom to check his BG. But if we’re in a place where such facility isn’t available or it’s an emergency situation I do what I have to do wherever I have to do it.


20 Hannah February 20, 2014 at 7:16 am

A) I love alliteration. B) This. Exactly. I was diagnosed T1 about 9 months ago, and I’ve never been embarrassed to take care of my health, nor will I allow anyone to make me feel that way. I test, I inject, and I go on. I don’t force it on anyone, the vast majority of people sitting next never even notice, and I love answering kids’ questions, because I want them to know what’s going on, and heaven forbid if it happens to them or someone they know, maybe it won’t take so long to figure it out. Diabetes is a part of my life, a very visible one, and I’m not about to try to hide that!


21 Leighann February 20, 2014 at 7:18 am

I love alliteration, too 🙂


22 Heidi February 20, 2014 at 8:01 am

I felt the same way as you. I don’t want my son to ever get the impression that we are ashamed of his diabetes. He was 7 when diagnosed and my inlaws didn’t like that we checked BG and gave injections in public. My FIL is squeamish of blood and my MIL saw people staring and was embarrassed or worried my son would be. So I talked to my son about it and asked him if he would like more privacy when we do those things and he said “No, I don’t want to have to go to the bathroom while everyone else is getting their food and then done eating before I can get started.” I told my inlaws how he felt and they started to see that my little 7 year old boy was proud to tell people who asked what he was doing. Most kids WANT to watch and it’s awesome that they can learn about diabetes through him. But the best moment was when, at McDonald’s, I overheard a father explaining to his son that some people have a disease and have to be very brave and give themselves shots every time they eat. The two of them then came up to my son and told him how amazed they were by his bravery, something than any 7 year old living with such a disease deserves to be told. So if you’re squeamish of blood, LOOK. AWAY. My brave boy will continue to take care of himself as he needs to.


23 Elle February 20, 2014 at 8:54 am

Well said Heidi.


24 Elle February 20, 2014 at 9:03 am

When I met my now husband, he always did his injections in the toilet. He grew up believing it was something he should hide from other people, because he was ashamed of his illness, and because he was worried about what other people felt. With some encouragement he quickly stopped it, and now does his injections and blood tests at the table. When our now 8yo son was diagnosed 3 years ago, I was determined to ensure he grew up knowing he had no reason to hide anything or be ashamed of anything. I am sensitive to his need for privacy, but at the same time have NEVER allowed him to blood test or inject/change cannula in the toilet. I would never breastfeed in the toilet, so won’t treat my son’s medical condition there either. While I understand that some people are needle phobic, or just don’t like seeing these things happen in public place, THEY DON’T HAVE TO LOOK! My son HAS to treat himself, he has no choice, but they do! We have lots of questions from other children (who are mostly fascinated) and adults, who always comment on his bravery. As parents we need to raise our children to care for themselves, openly, honestly and with respect. Surely the need to keep themself safe overrides anyone else’s discomfort?


25 Teri Law February 20, 2014 at 11:38 am

Great response! I totally agree.


26 Alex February 20, 2014 at 11:02 am

I love this. I was diagnosed at age 17, so I never had to deal with having it as a kid. But whenever I take insulin/blood sugar in public (or among friends), most people are either mildly curious or do not even notice. I’d say one of the bigger lessons I’ve learned from having diabetes is how oblivious most people are. I think people who get worked up about someone taking care of their diabetes in public are the kind of people who just like to get worked up about things.


27 Caroline February 20, 2014 at 12:08 pm

No. I would never test or bolus my child in a restroom. I would suggest the offended party go in there to shield themselves from the ‘dreadful business’ and would let them know it was safe to come out the moment we were done….no really, the very moment… ;-0


28 Charisse Jones February 20, 2014 at 3:37 pm

As a mom of a Type 1 diagnosed at 3, now 5. I have the same feeling that she shouldn’t feel ashamed because this is her life. I want her to be proud and have self worth in spite of this disease. As far as frightening children I have a positive response to that comment. Her pre-k class had what her teacher described as children who tended to whine and complain but after checking her in front of them they have a new respect for her and what she goes through and have changes their attitudes because of it. Most children see her as brave and it makes them want to be brave too. It is an excellent opportunity for a child to see to don’t have to fear needles.


29 Hayden Buller February 20, 2014 at 8:22 pm

I always give my daughter injections and check her where ever we are. The only time we go to the bathroom is to wash hands. Bathrooms are disgusting and I will never do anything diabetes related in a public restroom. So far I’venever had anyone say aanything to me about it. When we were at the doctor’s office there was a little girl who wanted to play and she was a year younger than my daughter (4). She came nack right after we did a finger prick and she was very concerned about blood being on her finger. I just told her sometimes we have to check her blood to see if she’s ok and she was totally fine with that answer. She asked if my daughter was ok then went about her business.


30 Michelle February 21, 2014 at 12:29 am

My son was diagnosed 7 years ago, and it never occurred to us to hide anything. We are discrete, and don’t do things to purposefully draw attention to what we are doing, but at the same time we don’t really try to hide it, either.
As far as upsetting or frightening other children, children are only frightened of things they don’t understand, or things that adults have taught them are scary. If a child is curious, all you have to do is explain it to them. Once you explain it, they really don’t care and usually just wander away. The only reason they would even give it a second thought is if an adult continued to make a big deal out of it.


31 J February 21, 2014 at 8:23 pm

Great post! I added your post to my list of bloggers who responded to Miss Manners. I am in the minority as an adult diagnosed with type 1 diabetes at the ripe age of 29. I often read blogs by parents who have children with diabetes. I really commend you for sharing your thoughts and experiences. I look at my parents, who are in their 60’s, and my heart aches for them. As an adult I can see and I think understand on a different level what they are going through. The fear, the worry, and although I am 100 per cent responsible for my diabetes management, I can see how much this disease has affected them. I will do what I gotta do! 😀 Thank you for sharing.


32 Kerry O February 27, 2014 at 12:37 am

My son was diagnosed at 3 years, 3 months of age. He is now almost 17. Not now, not ever, have we hidden him away for testing, injections, etc. We never made it a big deal. This is what we have to do, so we get it done. We have tested in restaurants, in movies, on planes, on buses, in friends’ cars, at Sunday school, at youth group, at school, at the playground, while hiking, while swimming, while cycling 100 miles in a day, pretty much anywhere and everywhere he’s been since the day of diagnosis. EXCEPT a public bathroom! Having said all of that, we have also been careful to not make it a big production. If a person was having a heart attack and needed a defibrillator, should they go to the bathroom? What about someone having a severe allergic reaction? Should they be taken to the bathroom to use their epipen?

Be responsible and bring your own disposal containers. The only legitimate complaint may be what happens with used syringes, etc. But, since none of us want to find anyone else’s used stuff, I am sure we all clean up our own… (although I have found those darned used test strips in every room of my house and in every nook and cranny in our vehicles. I swear they multiply with the dust bunnies!!!)

Kids will be kids and ask questions… We never hesitated to answer any question, even when the parents looked mortified that little Susie asked what he was doing. Let them ask… maybe the parents will learn something too!

Keep up the great work D-Mommas! It does get easier as they get older and can take more responsibility for their own management… The worry never goes away, you just adapt to it!


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