Guilt. The dictionary defines it as a feeling of responsibility or remorse for some offense or crime, whether real or imagined. Since diabetes is described as the classic example of a lifestyle-related, progressive disease, the opportunities for self-imposed guilt abound.

It's true that lifestyle choices do affect your chances of developing diabetes; however, they are not the only risk factors. And let's face it: guilt is unproductive, unhealthy, and can prevent you from making positive choices to manage your disease.

Why Diabetes May Not Be Your Fault

According to a study published in The Review of Diabetic Studies, we are all born with a certain amount of insulin resistance and a certain capacity to secrete insulin. As we age, resistance increases and capacity to secrete decreases. Resistance and capacity reflect a combination of genes, intrauterine environment, age, amount of fat tissue, lifestyle, and medications.

And guess what? Genes, intrauterine environment, and age are the most powerful factors-and the ones we can't control. The study says that although we can reduce fatty tissue and improve lifestyle to slow or prevent insulin resistance, over time, resistance may still exceed capacity to secrete and our blood glucose rises again.

Furthermore, Mark Hyman, MD, a functional medicine physician, says about 40 percent of skinny people have high blood pressure and cholesterol, making them metabolically obese and potentially at risk for diabetes, even though they are of normal weight.

If you're one of the nearly 26 million Americans with diabetes and feel guilty about your lifestyle choices, the best thing to do is acknowledge these feelings, let them go, and replace that energy with healthy behaviors.

5 Ways to Prevent or Delay the Onset of Type 2 Diabetes

Research shows that although family history is strongly linked to risk of developing diabetes, people may be able to prevent or delay onset of the disease. The National Institutes of Health recommend focusing on these five lifestyle factors.

  1. Follow a healthy diet. The quality of the food you eat is critically important, independent of the amount of calories you consume, says Hyman.  A qualified nutritionist can help you make good food choices.
  2. Maintain an optimal body weight.
  3. Get the recommended amount of physical activity.
  4. Don't smoke.
  5. Limit your alcohol consumption.

A final word on guilt: In the online diabetes forum,, participants discussed their guilt feelings.  One participant summed up the prevailing sentiments this way: " one should feel guilty at all about their's hard enough to manage on a day to day basis without adding guilt and blame to the mix. Let yourself off the hook and take control. That should make you feel better physically and emotionally."

Amber Taylor, MD, reviewed this article.


Patrick Phillips, "Type 2 Diabetes - Failure, Blame and Guilt in the Adoption of Insulin Therapy," The Review of Diabetes Studies 2(1) (205): 35-39, published online May 10, 2005 doi:  10.1900/RDS.2005.2.35.

"Guilt with Type 2 Diabetes?", accessed January 14, 2014.

"Six Lessons We've Learned Over the Past 10 Years,", accessed January 14, 2014.

"Diabetes and Guilt,", accessed January 14, 2014.

"Five Lifestyle Factors Lower Diabetes Risk," National Institutes of Health, September 19, 2011, accessed January 14, 2014.

Mark Hyman, MD, "Skinny Fat People: Why Being Skinny Doesn't Protect Us Against Diabetes and Death,", last updated February 21, 2013, accessed January 14, 2014.