There are a lot more factors at play — all more complicated than “I had a cupcake at lunch.”

How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

“I just ate so many cupcakes, I got diabetes,” a coworker joked from across the cubicle wall. Another group of coworkers erupted in laughter.

While the joke may seem harmless to them, I squirmed in discomfort.

They say the best kind of humor doesn’t punch down — but as a person living with type 2 diabetes who has to interact with this group of individuals almost every day, I couldn’t help but feel gutted by this so-called punchline.

For 30 million Americans, managing diabetes isn’t a joke. It’s an everyday reality of learning adaptive eating, taking pills, poking yourself with needles, or injecting insulin.

It’s a disease heavily influenced by genetics, one that you’re unlikely to be the first in your family to acquire — and yet, the persistent stigma remains: the way you eat causes diabetes.

But by oversimplifying this complex disease, we perpetuate the idea that diabetes is something someone deserves.

More than three years ago, I went to my doctor to get motion sickness patches for a cruise. I had a full physical so that my insurance would cover the visit, and to my surprise, my doctor called me back just a day before my cruise was set to depart.

That’s when he told me that I had diabetes. I asked a lot of questions starting with “Are you sure?” followed by “What caused this?”

As my line of questioning quickly turned into the self-blame game, my doctor said something that changed my outlook on my diagnosis.

He said, “For you, it wasn’t a matter of if you would get diabetes, it was a matter of when.”

There’s a reason that most doctor intake forms ask your family health history — and I can count on more than one hand my close family members (both living and deceased) that have diabetes.

In a2010 article “Intuitive Eating: Enjoy Your Food, Respect Your Body,” Dr. Linda Bacon and Judith Matz, LCSW, provide insight to understand this genetic disposition and end the blame game for good.

“Genes play a large role in the development of diabetes,” Bacon and Matz write. “We’re all born with challenges in our genetic code — as well as in our life circumstances — and this is one of the challenges you were dealt.”

“Your body was vulnerable,” they continue. “Difficulty with glucose regulation and some combination of factors triggered that genetic propensity.”

Triggered not caused — and this is a distinction that matters.

Many factors can place stress on a genetic predisposition like this — including chronic stress, which no one seems to focus on anywhere near as much as they do cupcakes — but the vulnerability itself is genetic, and not at all within our control.

And in this sense, eating sugar doesn’t cause diabetes. If that was the case, everyone with a sweet tooth would have diabetes.

The genes you’re dealt play a much bigger role in diabetes than many acknowledge. But when we gloss over this, it turns a disease worthy of empathy into a “punishment” for people who made “bad choices.”

The use of causation where it may be an association — or simply a factor among many — causes a lot of misinformation about diabetes.

As a self-proclaimed salt tooth, I can tell you that sweets were never something I craved. And yet I would still go on to develop diabetes, and people would make assumptions about my diet and body that simply weren’t true.

This is why joking about getting diabetes when you eat sweets as a non-diabetic does more harm than those laughs do good.

One cupcake won’t give you diabetes and joking that it will is dangerous on two levels: It creates misinformation about this disease and furthers the stigma that acquiring diabetes is something one has control over.

This joke also assigns a morality to food that can be harmful to those living with eating disorders.

Creating a hierarchy of value to food can encourage restrictive eating habits.

By saying that eating sweets gives you diabetes, you’re furthering this idea that food has an intrinsic “good” or “bad” value and that your punishment for eating badly is getting a disease.

This hits home for me especially as a plus-size person who lives at the intersection of diabetes and an eating disorder.

According to the National Eating Disorder Association, there’s a link between diabetes and the emotional state associated with eating disorders. They say that diabetes also doubles the likelihood of having clinical depression — another box that I check.

The National Eating Disorder Association adds: “A study of adolescents from Norway revealed that in addition to age, negative attitude toward diabetes and negative beliefs about insulin had the highest association with insulin restriction and eating disorder behavior.”

In other words, if being “fat” is thought to be the cause of getting diabetes, then disordered eating — based on fear of being fat — could be one’s attempt to prevent diabetes.

And in that sense, the stigma and misinformation around diabetes impacts us all.

The word “attitude” and “belief” both stand out to me here, though. Unlike genetic predisposition, attitudes and beliefs involve personal agency. One can change their attitudes and beliefs over time.

And this is exactly the place where non-diabetics can stop trying to be comedians and start being allies.

Rather than further the stigma with jokes, I challenge non-diabetics to rethink the way they think and talk about diabetes.

If you hear someone joke about getting diabetes, use that as an opportunity for education.

You wouldn’t joke about someone getting cancer — so what’s so humorous about diabetes? Both of them are diseases with genetic and environmental factors, right? The difference is who we typically imagine the face of the disease to be.

For diabetes, it’s those of us who society considers unsavory — larger-bodied folks and the elderly.

If you really look at it, your joke is nothing more than thinly veiled fatphobia and ageism.

If you don’t live everyday with diabetes, I wouldn’t expect you to understand what it’s like to have it.

However, I would expect the same respect every single person deserves.

Even growing up close to my diabetic grandparents, my outlook changed when it became my own reality.

I live a very full life with diabetes, and as a diabetic, I don’t ask for anyone’s sympathy. I would, however, appreciate basic recognition of my humanity.

Although I’m not insulin dependent, those who are face major accessibility and affordability issues for a drug they need to keep them alive. And I face my own set of challenges — from the rising cost of my glucose testing strips to covering up the bruises on my injection sites.

I don’t need to be at my workplace wondering what my coworkers really think of diabetes. It’s not helpful to me to make light of diabetes.

The words you use have power. Why punch someone down when you can help lift them up?

Alysse Dalessandro is a plus-size fashion blogger, LGBTQ influencer, writer, designer, and professional speaker based in Cleveland, Ohio. Her blog, Ready to Stare, has become a haven for those whom fashion has otherwise ignored. Dalessandro has been recognized for her work in body positivity and LGBTQ+ advocacy as one of 2019 NBC Out’s #Pride50 Honorees, a member of the Fohr Freshman class, and one of Cleveland Magazine’s Most Interesting People for 2018.