Here we are, just 12 days before Christmas, and as we rush to finish off holiday shopping, a perennial question comes to mind: What’s the etiquette on giving diabetes-related gifts to people who live with this condition?

Maybe the the song Twelve Days of Christmas can help us navigate that issue… given that it always pops up on the radio this time of year, chirping about the gifts “my true love gave to me.” But it’s never that easy in the real world, is it? One person’s true love’s got an apartment that’s too small for a tree. Or he or she is lactose intolerant, or has celiac. And pears are pretty high-carb anyway. Not to mention that having all those maids around might make someone’s girlfriend crazy-jealous. Oh, and keep those damn pipers away from me—my tinnitus is bad enough as it is.

Yeah. Holiday gift giving can be challenging. But wait a sec, should diabetes even come into the holiday gift-giving thought process at all?

Well, there’s no shortage of people saying that our diabetes, while not defining us, certainly defines what we ought to receive. From the dawn of Black Friday right up to the wire, we see a barrage of social media sites posting diabetes gift guides. You can find them at Beyond Type 1, Diabetes Strong, dLife, and TuDiabetes, among others.

Even the American Diabetes Association is in on the game with an online holiday gift shop featuring “presents” ranging from diabetes cookbooks (seriously?), to diabetes Christmas ornaments, to magnetic measuring spoons, to a Bluebird of Happiness Wind Chime. (OK, I’m not getting the diabetes connection to that last one.)

Meanwhile, I kid you not, if you search the topic on Google, the top hit is “gifts for a diabetic” at Amazon, a paid link. What’s the retail giant suggesting for us? Organic gift baskets, foot massagers, socks, Whitman’s sugar-free chocolates, medical jewelry, slippers, a small supply bag with bold white letters that reads “all my diabetes shit,” a fruit infuser bottle, and my favorite—a coffee cup that reads “proud owner of a useless pancreas.”

All of this got me wondering: Under what circumstances is it kosher to give a diabetes-related holiday gift to someone with diabetes? Does it make a difference if the giver is a sugar-normal or a fellow PWD (person with diabetes)? Parent or peer? What about the giftee’s age? And how might the choice of gift affect the equation? 

To take a read on this among our community, I broke diabetes gifts down into three broad categories: medical, functional and humorous—and then queried some well-known PWDs in our DOC for their feedback on how they’d react to D-stuff under their trees, in their stockings, or arriving on their door steps.


Medical Diabetes Gifts

Sure, we need a ton of gear and meds to stay healthy, and sometimes it can be hard to afford what we need. But does need make the gift? Personally, as a kid, nothing disappointed me more than getting a gift of something I needed, like clothing. I hated practical gifts then, and I still do now. Even if I needed a new glucose meter, I think if I ripped the bow off a present and tore into shiny paper to find a glucometer, I’d throw it at the person who gave it to me. But that said, there’ve been times when a box of CGM sensors under the tree would have been like finding a Lexus with a bow parked in the driveway, so circumstances—as well as personality—have a role to play here.

Long-time advocate and blogger Scott Johnson agrees, saying “If anyone in my circle heard me talking about how much I’d like a gift in this category, I’d appreciate it. But if it were unprovoked or assumed I’d want/need/use it, I’m not sure I’d like/use/appreciate it.”

Still, while Scott and I carved out some limited exceptions, most of the folks I talked to felt needles belong on the tree, not under it. The 2014 Diabetes Educator of the year, Gary Scheiner of Integrated Diabetes Services, a type 1 himself, says, “Medical stuff doesn’t seem like a ‘gift.’ I’d feel a bit slighted if someone gave me something medical as a gift.”

D-dad, blogger, and activist Bennet Dunlap agreed, pointing out that medical gifts “fail the Would this Bring Joy Outside of Diabetes? test.” He adds that, “While there are aspects of life with diabetes that are gifts—friendships, discovering personal strength and the like—a disease isn’t grounds for a gift.”


Functional Diabetes Gifts

OK, so what about practical gifts that aren’t specifically medical, but have functional value in Diabetes Land? Gym memberships. Fitbits. Cooking tools. How do those go over?

Practical gifts, points out Dunlap, are, “risky territory,” diabetes or not. “Try giving your spouse a frying pan,” he says. But to reduce the risk, he has another test to offer: “I would suggest the Who Benefits? test when trying to decide if a practical gift is appropriate. If there’s any chance that you, as the gift giver, will benefit from the gift, proceed with extreme caution.” He also feels that that if you’re giving practical diabetes gifts, “there better be other non-diabetes stuff under the tree and in the stocking.”

Still, functional gifts can be a big score. D-advocate and blogger Kelly Kunik says that one of the best diabetes Christmas gifts she ever received was a gym membership given to her by her mother. “It wasn’t specifically for my diabetes, it was because I wanted and needed to work out. I really appreciated (and used) that gift!”

And that seems to be the key, says Scheiner. “Practical gifts are nice to get, especially if it’s something I can really use.” The problem is that, “People often assume that we need something that we don’t really need.”  So how to sort out what you think someone needs and what they really want and need?

The American Association of Diabetes Eductors’ on-staff educator Joanne Rinker says, “Diabetes themed gifts can be a thoughtful option for people with diabetes, but it definitely depends on the individual.” She suggests “to be sensitive to this, consider running a handful of diabetes related gift ideas by your family or friends to see if they are of interest. If they aren’t, then that’s your cue to choose a more traditional, non-diabetes-themed gift.”


Diabetes Humor Gifts

The biggest laugh I’ve had in a long time was when I saw a T-shirt with a picture of a human arm bone and the tag line: I found this humorous.

I love that kind of word play.

Likewise, there’s no end of clever diabetes T-shirts, hats, patches, buttons, coffee cups, posters and coasters. And this is the one area where my fellow PWDs generally agree that they are open to in the diabetes gift department. Scheiner not only likes humorous gifts, but feels they serve a need, saying, “Gotta keep a sense of humor or we’ll all just explode from stress.”

Dunlap feels that humor is fair game as long as the health condition is the joke, not the person with the condition. He also says to be sure everyone’s sense of humor is aligned. Tricky that. One man’s humor is another man’s insult.

The safe bet on this front is to keep it in the “family.” If you are a PWD, then anything you find funny will likely tickle the funny bone of one of your diabetes brothers or sisters. Johnson says he particularly appreciates diabetes humor gifts when they come from “my diabetes homies.”

One caveat: It seems that about half of the diabetes humor items use the now out-of-fashion hot button word “diabetic.” If the gift givee is a fan of the term Person with Diabetes—not a diabetic—then the best-intended gift may backfire.


Age Matters

But medical, functional, or humorous, all my peers agreed on one thing: Skip the Big D when it comes to the little ones. Scheiner says, “Kids generally want things that are fun, and like the things that their friends get.” He recommends staying away from diabetes-related gifts for kiddos altogether.

Dunlap is on the same page, saying to remember that, “Kids are kids. The holidays are BIG for them and diabetes probably isn’t their focus. Why bring it in?”

Johnson flatly says, “I think diabetes-related stuff should be off the table for kiddos.”

We wondered if there was any empirical research on the subject, so we naturally reached out to Dr. William Polonsky of the Behavioral Diabetes Institute. He wasn’t aware of any hard data, but offered the following simple advice from his own life: “When I was a little kid I was always seen as the smart one in the family, and so for birthdays and holidays, I always received dumb crap like dictionaries and encyclopedias as gifts. That was so disappointing. I just wanted toys like everyone else.”

Kunik sums it up simply by saying that when it comes to little ones: “Get the gifts that they ask for.”

All of that said, we can’t see the harm in a new pack of Pump Peelz as a stocking stuffer. But there is one diabetes gift that’s universally reviled…


Sugar-Free Candy for Diabetes? 

Until you’ve actually had the misfortune to consume it, sugar-free candy sounds like a good idea for people with diabetes. Of course, not only is it awful, but a gift of sugar-free candy is the gift of ignorance: PWDs can perfectly well have regular candy. Kunik says the worst D-related Christmas gift she ever received was, “Gross ‘diabetic chocolate bars.’ Disgusting and inedible.”

Indeed, these “diabetes friendly” treats are often packed with chemicals that forced them to be malabsorbed by your intensines, creating stomach problems. Ugh.

Scheiner adds that a treat should be a treat. “We can always take insulin for the occasional treat. There’s no need for something ‘sugar free’ that doesn’t taste all that good, gives us gas, and still raises our blood sugar.”


Or Just Say No 

If there’s any doubt, the safest bet is to buy for your D-loved ones as if they didn’t have diabetes at all.

In fact, the Mine’s own Rachel Kerstetter shared some personal thoughts on this topic recently, and she sums it up well: “Most people with diabetes want to be seen as more than their illness, no matter how much they blog, tweet or post about it online. Look at your friend or relative as a person outside of their diabetes with their own unique personality, interests and hobbies that can provide you with plenty of ideas for gift giving.”

Additionally, D-Dad Dunlap offers this final piece of advice: “Gifts are for the unique celebration of your family, tradition, and faith. Diabetes chronically sucks. Why bring suckage from any source into your unique celebration?”

True that.

Happy (Non-Disease-Focused) Holidays, All!