Masculinity, Sports, and Diabetes Stigma
What happens when a culture of toughness intersects with a chronic condition that demands vulnerability?
The diaTribe Foundation’s own Derek Helm is no stranger to balancing the competing demands of diabetes.
Starting as the point guard on his varsity high school basketball team meant juggling two identities: one shaped by sports culture, which told Helm to be tough and unshakable, and one shaped by his recent diagnosis of type 1 diabetes, which required him to pause, check in, and prioritize his health. On the court, only one of those sides of himself felt acceptable to show.
For Helm, like many athletes with diabetes, meeting expectations meant hiding his diabetes management. He often played with blood sugars over 250 mg/dL, afraid of going low mid-game and equally afraid of showing what others might perceive as “weakness.” The strategy paid off in the short term – he earned multiple awards and was part of a historic season for the team. But the cost was burnout, missed opportunities, and years of unlearning the harmful messages of stigma and a narrow definition of strength.
Acknowledging the culture of masculinity in sports
When it comes to playing sports, especially contact-based and team sports, there is often an unspoken culture that demands grit, sacrifice, and strength.
This is something that Chris Bright, who lives with type 1 diabetes and is the founder of The Diabetes Football Community and Wales Futsal International, knows well. Futsal is a fast-paced indoor variant of soccer or football.
“These ideas stem from traditional norms of masculinity and are deeply rooted in sport and society, but they can be harmful to everyone, not just men,” Bright said. “They can discourage vulnerability, openness, and asking for support, which are essential when managing something like type 1 diabetes. In sports, this mindset can lead to burnout, poor health outcomes, and isolation.”
When the message is “don’t be the weak link,” diabetes can feel like an unwanted spotlight. Helm described how pausing to manage a low felt like being exposed as less capable than others. Teammates would stare or comment, and coaches would express concern about whether he could play during blood sugar swings. Would being transparent about the challenges of diabetes mean getting taken out of the game, losing the starting spot, or losing the trust of the team?
“In elite sport, there’s pressure to appear invincible,” said Bright. “Saying to others that you have a chronic health condition can feel like revealing a weakness and showing a chink in your armour. So athletes often hide it to avoid being judged, dropped, or seen as ‘less capable.’ I’ve felt that pressure myself, to keep it quiet, to not let it ‘define’ me.”
Stigma, sports, and identity formation for people with diabetes
For some people, sports are a core aspect of self-image. This may be especially true for adolescents as they form a sense of identity and belonging. When stigma pressures someone to hide their diabetes management, as Helm did, the message is clear: This part of you doesn’t belong. Over time, that can create burnout, shame, and disengagement from care.
Bright has found through his work in the soccer and futsal communities that people who center too much of their identity around sports while rejecting the idea of incorporating diabetes into their self-concept may end up neglecting their diabetes self-management.
“When you embrace diabetes as part of your identity, it shifts everything,” Bright said. He added that this mindset shift also helped him appreciate his unique strengths.
“It’s built my resilience and self-awareness,” he said. “I’ve also found a community through embracing my condition, not hiding from it or concealing it. On the pitch, it helps you advocate for your needs and ensure you’re supported. Off the pitch, it helps you connect with others and challenge societal stigma.”
Research demonstrates that youth who develop a positive sense of identity that incorporates diabetes are more likely to manage the condition successfully into adulthood and have better mental and emotional well-being.
Stigma and exclusion in sports
When it comes to engaging with any kind of physical activity, people with diabetes may encounter misconceptions or stereotypes that they are weak, fragile, lazy, or unhealthy.
In addition, tools to help people manage their condition – such as an insulin pump or continuous glucose monitoring (CGM) – and self-management behaviors – like pausing mid-game to take injections or sitting out to treat low blood sugar – can become unwanted sources of attention.
“Instead of learning to integrate the masculine version of me that was strong, dependable, and steady with the more vulnerable version that needed to pause, ask for support, and prioritize my health, I treated these sides of my identity like they were at odds,” Helm said.
Navigating diabetes stigma and struggling to incorporate diabetes into his identity ultimately magnified the burden of diabetes for Helm. By the time his senior year rolled around, Helm didn’t return to basketball – despite being on track to have his best season yet.
“It’s common to hear of people with diabetes dropping out of teams or avoiding trials because they fear being judged for their diabetes. I’ve also heard of many players being sidelined, barely playing because of a coach’s own fears or perceived lack of trust in that player. This kind of stigma leads to self-exclusion, where people remove themselves before anyone else does,” Bright explained.
Self-exclusion from sports or exercise is just one of the many harms of diabetes stigma that has been validated by research. Increased experiences of stigma have also been shown to impact people's engagement with diabetes management and correlate with social withdrawal and isolation. In addition, weight stigma, which also commonly overlaps with diabetes stigma, has been shown to have similar impacts.
Challenging traditional norms and diabetes stigma through sports
For all the challenges they bring, sports also hold tremendous potential to break down these harmful norms.
“Masculinity in itself is not a bad thing, but it can manifest in unhealthy ways,” Helm said.
Many of the skills learned through sports, like perseverance, accountability, and teamwork, are important on and off the court and may actually support diabetes management skills. After all, diabetes often demands that we show up and put in the work, even when we don’t want to.
“Real strength also means taking care of yourself and asking for help,” Helm said. “Real leadership means knowing when to step back, not just when to push forward.”
Hiding his diabetes prevented Helm from learning these lessons when he needed them most, but now he thrives practicing jiu-jitsu and as an avid surfer.
Bright and The Diabetes Football Community lead football camps for people with diabetes that help youth with diabetes learn wisdom like this before harmful stigmas can take root and put people on the sidelines.
“We foster a like-minded community that comes together for the sport first, but then provides the opportunity to seek out support for diabetes second,” he said. “The positive association of the shared love of football builds a subtle link with their condition, which grows and builds connection, community, and ultimately, a buffer from stigma.”
Through storytelling, knowledge sharing, and peer support, community events like these help normalize diabetes in sports, build a positive sense of identity around diabetes, and empower people to keep moving and playing.
The bottom line
For athletes with diabetes, redefining strength can mean treating a low in front of teammates, wearing devices openly, or asking for help when needed. These acts push back against stigma by modeling a healthier, more inclusive version of toughness – one that makes space for both resilience and vulnerability.
Learn more about diabetes and sports here: