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AskNadia: Asked to Leave Restaurant for Openly Injecting Insulin

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 bolus 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 bolus 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 really had no choice but to ask you to leave.

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. First, think about buying bolus insulin pens. They are far more discreet because the injection needles are hidden, and the pens look far less menacing than syringes.

Second, 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. Remember that the restaurant, provided the staff has been taught to see insulin injections as nothing extraordinary, was reacting to your “butt” remark, not to you injecting in public.

Of course, after years of putting up with rude or obnoxious people, you were ready to blow your top. The problem with doing so was that it cost you a restaurant meal you were looking forward to. I hope that this was a one-time thing for you.

One Woman’s Experience

Our type 1 correspondent Meagan Esler wrote about injecting insulin in public. Here’s what she had to say:

Recently, there has been a great deal of discussion on the subject of testing your blood sugar and taking insulin shots in public. A shocking number of people on social networks have commented that their family members don’t want them to test their blood sugar or take their shots in public. They report having to inject in restrooms or even through their clothing to avoid drawing attention or offending their families. One hypersensitive husband even objected when his recently diagnosed wife took a shot in the relative privacy of their car.

Sometimes people resolve this problem by getting a pump, which makes insulin delivery much less noticeable. But insulin pumps are financially out of reach for many, even those with insurance coverage, and a good number of people just prefer injections to a pump.

I used to be among those who hide their diabetes. Hiding was a way of telling myself and others that I thought something was wrong with me. While I was hiding, everyday life was far from happy. I used to take my shot in my car or run to the restroom before going into a restaurant. It was a little like playing Russian roulette because I could never be sure I’d be seated right away and get quick access to carbohydrates. It definitely wasn’t a smart plan of action, but I was younger and willing to do anything to avoid the stares of other patrons as I whipped out my test strips, lancing device, insulin bottle, and syringe. I dreaded looks of pity, expressions of horror, or any attention whatsoever.

Thankfully, my husband, children, friends, and family are more than understanding when I need to test my blood sugar or inject in public. Truthfully, they have no other option because I have made peace with having diabetes, and I simply refuse to hide anymore. I personally take five to six shots a day with a syringe, which is way too many to worry about hiding. I will take my shot anywhere: at my desk at work, at the local coffee shop, and even in a crowded movie theater by the light of my phone. As a person with diabetes, keeping my blood sugar level is more important than being shy.

I have also come to believe that taking a shot in public helps spread awareness about diabetes. It shows people that anyone can have this disease. Of course, I am discreet about taking my shots. I certainly don’t wave the syringe around or make a scene. I simply take my shot and move on with my day.

Accepting diabetes and doing what we need to do to survive shows how strong and resilient we are. We should be nothing but proud!

Best of luck, Richard.

Nadia

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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