5 stages of diabetes acceptance

Peace and acceptance jigsaw puzzle

TuDiabetes blogger, Rick Phillips, has lived with type 1 diabetes for more than 40 years, and grew up with a mother and aunt with type 1 diabetes. In this time, he’s come to understand that diabetes is as much an emotional journey as a physical one. The emotional journey is often a twisted road with many detours. Rick believes it is one all people with diabetes must undertake in order to maximize life with diabetes. 

It is generally agreed that there are five stages of grief. Readers might ask how being diagnosed with diabetes equates to grief. Grief occurs anytime we experience loss. Diabetes fits that description very well, because when diagnosed, one often feels a loss of independence or the opportunity to live life on one’s own terms. I know, of course, this is not the case, but for a newly diagnosed person with diabetes, they are often overwhelmed with thoughts of all they have lost. Those feelings of loss often initiate the process of grieving, either for the person with diabetes, the family, or both.

The first stage of grief that most experience is denial.

One simply decides to live as if we are not a person with diabetes. We do not care what happens to us or how to move past the initial shock of the situation. In order to get past this step, one must first take responsibility for their condition. I believe it is important to encourage as much responsibility for the management of diabetes as soon as possible. Of course there are appropriate boundaries, but the sooner a person takes responsibility the better chance of not becoming stuck in this dangerous stage.

The second stage of grief is anger.

One may feel their potential has been tampered with, additional restrictions have been imposed, and life has been altered. This is a difficult stage to move beyond. Often when stuck in denial, it is because we do not yet want to face the potential consequences of our disease. However, knowledge of complications alone will not help many people move forward. In my case, I often try to find others to help so that I may look outside of myself.

The third stage of grief is bargaining.

People with diabetes are often excellent bargainers. When I was diagnosed, I learned how to bargain with my doctors, parents, and school officials about diabetes. These, of course, are one sided bargains. No matter if we strike a deal to avoid a test, or fake out our spouse or parent, we bear the ultimate burden. 

Perhaps the worst bargain I ever made was to delay getting my first Medtronic insulin pump. At the time, I had been living with diabetes for over 26 years, and my wife had been asking me why I did not try a pump. My response always included an excuse. I told her I wanted to put it off, and would often explain to her why it would not work for me. Then I met a small group of students who attended a high school where I was an administrator. Of the seven people with diabetes in the room, I was the only one without a pump. I left the meeting and called my doctor’s office. I told the nurse I had decided to get a pump and two weeks later, I had my first Medtronic pump. I have never looked back and have often wondered what took me so long to make that decision. Getting the insulin pump has been the best decision about my diabetes care I have ever made.

The fourth step of grief is depression.

I know I usually become depressed when my bargains fail. When my doctor calls my bluff or my wife asks I test my blood sugar, and it was low, while I am contending I am fine. I am depressed when my best laid plans to avoid diabetes are not enough. This can lead to outbursts or sometimes withdrawal. However, a seasoned person with diabetes learns to adjust when they find themselves in this state of grief.

Finally, we are told that following depression we find acceptance.

Of course, to some degree, acceptance is forced on people with diabetes. The day we give our first injection or take our first pill or first start pumping, we have tenuous acceptance. There is a difference between compliance and acceptance. What often looks like acceptance is often tacit compliance. We must learn to acknowledge that compliance is good. However, acceptance is what we must achieve in order to live with diabetes. 

Even 40 years after my diagnosis, I still must replay many of these steps. There is no diabetes nirvana. It is a process, one I have to relive most days as I move forward and back along the continuum of emotions. The key for all of us is not getting stuck. We must realize that acceptance of diabetes is a complex and ever evolving process. I have not concluded my journey of accepting diabetes, I doubt I ever will. But I have evolved a great deal, just as all people with diabetes inevitability must do. It is this constant evolution though the stages of grief that helps me to be ready for the next challenge right around the corner, whatever that might be. 


About Rick Phillips 

Rick has been married to his wife, Sheryl, for 37 years. They have two sons, ages 32 and 35, who he loves more than life itself, and are blessed with two wonderful daughter-in-laws, and three brilliant grandchildren, ages 3, 4, and 6. Sheryl and Rick met during senior of high school, following the summer of his diagnosis. He asked her out three times, and she said no three times. Then, one year after high school graduation, Sheryl called Rick, letting him know she was available. 

Rick’s mom was diagnosed with type 1 diabetes in 1963, and his aunt in 1947. His mother was a control subject for a 1969-1970 insulin pump study at Indiana University. His first glimpse of an insulin pump was on a cart in this hospital. The technology made them wonder in amazement, and still does. 

Medtronic Champion Rick


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Submitted by Irene Alperstein (not verified) on

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, I have lived with diabetes for over 67 years and did go through the 5 steps. Today, living with diabetes has been so much easier due to the pump and all the advances in diabetic research. Thank you, Rick, for your insights

Submitted by naomi.kingery@… on

In reply to by Irene Alperstein (not verified)

Irene, I’m happy to hear you’re doing well on insulin pump therapy. We appreciate your view point and are so glad that you enjoyed this blog.

Submitted by sue Williams (not verified) on

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Thank you for posting the 5 stages of diabetes. I too find myself traveling the journey several ties over and I am glad to find other who are experiencing the same things

Submitted by naomi.kingery@… on

In reply to by sue Williams (not verified)

Sue, you are definitely not alone in your journey with diabetes. We’re always here for you. Thanks for sharing with us.

Submitted by Karen (not verified) on

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Thanks for sharing, Rick. This post really spoke to me - especially the last paragraph. Although I know I've accepted that I've had diabetes (for over 35 years now), the process of moving forward and back definitely continues.

Congratulations on 35 years, Karen. Thank you for sharing your experience with us.

Submitted by Joan (not verified) on

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thankS for the post, I have type 1 diabetes since I was 14, I have come across the 5 stages but reality sink in with me that life is beautiful even if
I'm on my insulin pump!

Submitted by naomi.kingery@… on

In reply to by Joan (not verified)

Joan, thanks for sharing your positive spirit with us!

Submitted by Irene Norusis (not verified) on

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My boyfriend found out that he is diabetic. He can not accept it.

Submitted by Andrea (not verified) on

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I got diagnosed with type 1 diabetes 1 year ago. I am 30 years old. I seem to be stuck in the grief, depression and denial stage. I just cannot accept it. It is a daily struggle. I feel like throwing my life away just for the immediate satisfaction of food. I am not overweight for some miracle but I love eating. I am obsessed with food, I feel like an addict who just can’t seem to kick the habit even if it’s costing me my life. I am an emotional eater which makes things that much more difficult for me. I eat when I’m happy and I eat when I’m sad.
I found some comfort in reading this article— knowing I’m not the only one...

Submitted by Sandy (not verified) on

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I’m Type 2 diabetic, and I have not arrived at acceptance and really honestly I don’t think I ever will, I love food to much. I’ve been through all stages of grief, but have not showed my anger because it’s so unexceptional in our society. I am filled with anger and don’t know how to process it. Writing in a journal DOES NOT help, I’ve been told this so often to journal about how I feel. My mom passed away from cancer it will be 5 years in Nov. I was diagnosed with diabetes in 2012 I became very scared of this disease and my mom was my comfort I wasn’t as scared when I was around her. When she passed away in 2015 I’m more scared then I was before her death. I thought how am I going to live with this disease without her. I was devastated when I found out she had cancer, I was freakin scared I don’t want to lose my precious,loving mom. She was my rock for everything in life we were close. She was my best friend, so when she died I didn’t care about anything, and my diabetes , my life was empty, and I was a disaster. Now I’m very lonely without my best friend, I long for her we were so much the same. I don’t have a dad she was both mom and dad, I felt so protected from all the hard things in life. Diabetes gets me down, when you socialize before Covid, what is always there , Food. I get kind of panicky , there’s nothing there I can eat then to be polite I eat a little of this and a little of that, you just can’t relax, like before having diabetes, I never had to watch every piece of food I put in my mouth, it’s the most relentless disease. I really hate it. I could go on and on but I’m pretty sure you all know where I’m coming from.

Submitted by April (not verified) on

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HI im a mother of 1 year old boy ,he's name is jacob Liam few days back my. Son git diagnosed and the doctor said he has type 1 diabetes, im really sad for hin cause he's too young for this.i dont know what to do.

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