When Diabetes Becomes a Conversation, Not a Condition
By Jane Wangare, Clinical Psychologist
Psychosocial support for young people with diabetes is often missing from clinical care, a recent peer forum in Nairobi showed why that has to change.
Beyond Blood Sugar Readings
I have always imagined an open forum for young people living with diabetes, a space united by a shared diagnosis, but not defined by it.
A space where young people can be more than their blood sugar readings, HbA1c results, insulin doses, or clinic appointments. A space where they can ask the questions that feel too embarrassing, too complicated, or too unrelated to bring up during a routine clinic visit.
Questions like:
“Why is it easier to manage my diabetes at home than at school?”
“Am I doing carbohydrate counting wrong, or is it normal to still feel hungry?”
“How do I talk to my friends about diabetes?”
“How do I manage weight, appearance and Muscles while living with diabetes”
“How do I manage diabetes when money is tight?”
The Forum: A Day of Honest Conversation
Last Saturday, that vision came to life. About 30 adolescents and young adults living with diabetes gathered in Kenya Diabetes Management and Information Center [DMI] for a day of conversation, learning, reflection, and connection.
There was no pressure to have the right answers. No expectation to be the “perfect patient.” Just an opportunity to talk honestly about what life with diabetes really looks like.
Using the Diapsych Diary; a structured tool for reflecting on communication, relationships, and emotional wellbeing ; we explored coping with the everyday realities of living with a chronic condition. Participants shared experiences, asked questions, challenged assumptions, and learned from one another.
What Diabetes Management Doesn’t Show on a Chart
What emerged from the discussions was a reminder that diabetes management extends far beyond medical care.
One participant shared that managing diabetes feels easier at home than at school, where meal options are often limited and routines are harder to control.
Another spoke about struggling with carbohydrate counting, explaining that following recommendations sometimes left them feeling hungry and uncomfortable asking for additional food. Others admitted they still did not fully understand carbohydrate counting and welcomed the opportunity to seek further support from diabetes educators and nutrition professionals.
A conversation that particularly stood out focused on finances. Several participants discussed the cost of living with diabetes and the pressure that financial challenges can create. It was a powerful reminder that financial wellbeing and health outcomes are deeply connected, and that young people need practical life skills and financial literacy alongside clinical education.
Another theme that emerged repeatedly during the forum was body image. While the conversation initially focused on fitness and muscle building, it became clear that many of the questions reflected deeper concerns about confidence, appearance, and self-perception.
Participants discussed how living with diabetes can influence the way they view their bodies and compare themselves to their peers. The discussion highlighted the importance of addressing body image as part of diabetes care and created an opportunity to explore healthy approaches to nutrition, exercise, and self-acceptance. It served as a reminder that supporting young people with diabetes involves caring for both their physical health and their relationship with their bodies.
Why Shared Experience Changes Everything
Perhaps the most valuable outcome of the day was the realization that many of these challenges are shared.
There is something powerful about sitting in a room with people who simply understand and recognize the frustrations, fears, victories, and everyday negotiations that come with managing a chronic condition.
The forum reinforced something I strongly believe: psychosocial support should not be an optional extra in diabetes care. It should be part of the conversation from the beginning.
Because young people do not just need information. They need spaces to ask questions, opportunities to connect, and permission to talk about the parts of diabetes that do not show up in clinic notes, and sometimes, they simply need to know that they are not alone.
A Conversation Worth Continuing
As a Diabetes Psychologist, moments like these remind me that young people do not need more lectures about diabetes. They need spaces where they can be honest about the realities of living with it. When we create those spaces, we learn that the challenges are often shared and so are the solutions.
That was the purpose of the forum. And judging by the conversations, connections, and reflections shared throughout the day, it is one worth continuing.
Further Reading
Okonji et al. – Psychosocial Support Interventions for Improved Adherence and Retention in Care for Young People
World Health Organization – Improving the Mental and Brain Health of Children and Adolescents
Do you work with young people managing diabetes or another chronic condition? I’d love to hear how you’re creating space for these conversations.
It is true that diabetes care needs to involve everyday struggle and not confined to clinics and insulin titration. Thanks for sharing. It is indeed an eye opener.
Am aware that young people need personal space not lectures sa as to be honest about the realities of living with daibetes