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DAN Presidents Message:
Diabetes and National Federation of the Blind Philosophy

by Mike Freeman

The Diabetes Action Network (DAN) is a division of the National Federation of the Blind (NFB). One of the great strengths of NFB is its positive philosophy of blindness. The essence of this philosophy is first, being blind does not impair mental ability; second, most of the problems faced by the blind are caused or made worse by the fact that we are a small minority in a sighted world and are subject to misunderstandings and misconceptions; and third, with ingenuity and imagination, we can devise alternative techniques to perform most tasks that people often believe require sight. Put simply, we of NFB believe that attitude counts far more than visual acuity, and that when faced with a task, the blind person should ask, “How can I do this?” rather than, “Can I do this?” This is a message of hope; it is a belief based upon the experience of NFB members who lead normal lives.

This philosophy fits well with good diabetes care. We of DAN know that with a few adaptations and special devices, we can control diabetes as well as sighted diabetics. Yet not everyone shares this belief.

Consider the insulin pen. Many diabetics (both sighted and blind) find the insulin pen a convenient and accurate means of injecting insulin. Yet both Eli Lily and Novo Nordisk place a warning on their insulin pen packaging and instructions for use explicitly stating that blind or visually impaired persons should not use these insulin pens unless supervised by a sighted person. Given the experience of many blind diabetics who use insulin pens without difficulty, I must conclude that these warnings are based upon little more than the erroneous assumption that because of the markings on the insulin pens, sight is required for their use. This is very familiar reasoning to us in NFB; we often encounter situations where sighted persons prohibit or discourage us from doing things because they cannot imagine how they would do these things if they were blind. This translates directly into decreased opportunities for the blind. In the case of insulin pens, it is not hard to envision situations in which diabetes health care professionals might well discourage blind diabetics from using insulin pens due to their warnings, when insulin pens might be useful to achieve good diabetes control.

Fortunately, many diabetes health care professionals are using common sense and ignoring these warnings, correctly noting that most insulin pens are easy to use and that there are ways to work around certain aspects of insulin pen use that seem to require vision. (For example, successfully doing air shots or keeping track of how much insulin is left in the pens/cartridges.) But we of NFB cannot assume that all diabetes health care professionals will understand, so we have adopted a policy to encourage Eli Lily and Novo Nordisk to remove warnings against pen use by the blind or visually impaired from their insulin pen packaging and instructions (see Resolution 2008-07 elsewhere in this issue).

But there is still work to do. In the July, 2006 issue of the American Foundation for the Blind’s (AFB’s) electronic publication “Access World” at, there is a rather good article reviewing the various insulin pens available in the U.S. at that time in terms of  use by the blind. The descriptions of the various insulin pens and the analysis of the tasks needed to use them are both excellent. Yet the task analysis is suffused with the assumption that tasks for which sight is normally used are fraught with difficulty. No doubt a few blind and visually impaired persons might find some of the tasks more difficult than they might find them if they were sighted (keeping track of how much insulin is left in a pen comes to mind) but the assumption that such tasks are necessarily difficult is unwarranted. We of NFB will not rest until the assumption that blindness equals incompetence is eradicated from the public mind. Through the Diabetes Action Network and the Voice of the Diabetic, we are spreading the gospel that diabetes and its attendant complications such as blindness can be successfully managed, and that people with diabetes (blind or sighted) can live normal, happy, productive lives.

If you are not a member of the NFB and/or DAN, please join us!