Aren't you ashamed of yourself?

Most of us can still remember those words of admonishment from our mothers years ago. And many of us berate our kids with that phrase now.

When what we do is bad -- when we violate the Golden Rule -- the innate sense of shame that all normal people have can lead us back to ethical behavior. This normal human emotion can bring us to maturity in our actions.

But many of us are ashamed of who we are or the diseases we have. We feel shame about the physical condition of our bodies.

People who have type 2 diabetes often have an overdeveloped sense of shame. We buy into the conventional wisdom that with our degenerate lifestyle we brought on our diabetes ourselves.

Indeed, a medical dictionary defines a lifestyle disease as one "associated with the way a person or group of people lives. Lifestyle diseases include...type 2 diabetes."

I don't doubt that the pounds I gained and the exercise I avoided in the 1980s contributed to the diabetes that I learned in 1994 that I have. I was working 60 or more hours per week in a demanding job as a magazine editor. The publisher of the magazine and culture of this country approved of my lifestyle.

At the time I didn't feel ashamed being a hard-working person who gave more to my job than to taking care of my body. I didn't know then what I know now about diet and exercise. And I didn't know that I had a genetic predisposition to getting diabetes.

"Type 2 diabetes has a stronger genetic basis than type 1," says the American Diabetes Association. And recently when I got a DNA test for a genetic variation that is a risk factor for diabetes, sure enough I had that genetic predisposition.

Most of us with type 2 diabetes probably have those bad genes. Should we feel ashamed of our genes?

Those of us who have diabetes have bodies that are less than perfect. But that's no reason to be ashamed of them. In fact, body shame can be counterproductive. It can mask what we can do to control our diabetes.

When we really get to know other people, we find that essentially everyone is flawed. I like to think of all of us as diamonds -- flawed diamonds.

Shame at the condition of our bodies remains strong in our culture. But probably not as strong as it once was.

My mother was ashamed that she had epilepsy. She never had a seizure after starting to take Dilantin when I was three years old, and she insisted that my father never tell me about her disease. Since epilepsy is a disease of the mind, our culture felt then that it was particularly shameful. But my father thought that my sister's children and grandchildren could inherit my mother's epilepsy, so he eventually told her. It wasn't until my mother was in her 70s that my sister told me. I think now that it was shameful that I didn't know earlier, because I would have appreciated my mother a lot better.

Last year when I had an operation to relieve an enlarged prostate -- a transurethral resection of the prostate or TURP -- it was successful. I had feared two possible consequences of the operation, urinary incontinence and erectile dysfunction. I did temporarily have to wear pads, but that's not something that I was or am ashamed of.