Intended for healthcare professionals

Practice What Your Patient is Thinking


BMJ 2019; 364 doi: (Published 06 February 2019) Cite this as: BMJ 2019;364:k5258
  1. Renza Scibilia,
  2. Chris Aldred
  1. Find Renza and Chris on Twitter at @RenzaS and @Grumpy_Pumper

Renza Scibilia and Chris Aldred write about how to take the blame out of complications and their determination to reframe the way complications are discussed

People with diabetes and other chronic conditions know all about disease related complications. They are told about them by healthcare professionals, organisations, charities, public health campaigns, and the media. Often the information is presented in such a way as to suggest that the affected individual is to blame for the development of complications because he or she failed to manage the condition “correctly.”

In our combined 45 years of having type 1 diabetes we have had less than ideal conversations about complications with our healthcare professionals.

Blame, shame, and complications

Last year I (Chris) received a diagnosis of a foot ulcer. Using social media and the hashtag #TalkAboutComplications, I started to tell the story of my experience after this diagnosis. The huge response from people wanting to share their stories showed the interest in discussing complications in an open way.

A recurring theme was feeling “blamed and shamed” by healthcare professionals when a …

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