D&D General Diabetes in dnd

[tetrasodium]

Prior to the 20s & 50s (insulin & dialysis became available) diabetes was a pretty awful end & was widely considered to be a wasting disease.


Diabetes is complicated though because it's a two part problem. The first part is insulin & blood sugar problems, This one is tough since neither is poison until the levels are so far one way or the other that the diabetic has other problems. The second part is the way those two being out of wack causes damage the kidneys & other parts of the body. Some of those problems in the second part are poison.

Spells like (lesser) restoration might have be a functional stand-in for dialysis, but that's a thing that needs fairly regular treatment like daily to weeklyish depending on type of dialysis& diabetes type/kidney function so they might expect to need it just as often.

I highly doubt that cure spells would have much of an effect. Even if a cure spell helped do things like stabilize blood sugar levels you still face the problem of those levels going back out of wack as you continue to digest food & such. If cure wound helped I doubt anyone but those who could afford spells like wish & regenerate could afford theneed for a small army of clerics devoted to casting it on them throughout the day.

As to controlling blood sugar levels I'm not sure that any spell shy of stuff like wish & maybe regenerate would cover it even with a super permissive reading.

Setting plays a part too. A diabetic living in most parts of Khorvaire (Eberron) might have a steady supply of blood sugar control potions working at least as well or better than modern insulin pumps & the ability to visit a Jorasco enclave where a magewright performs a dialysis type equivalent service

 

[Starfox]

If a player character starts out with diabetes type 1 and wants that to be a plot element in the campaign, you don't want it to be curable. Like the Pathfinder Oracle's curses, it would be a part of your natural state and thus the point to which all restoration and healing spells retore you. Just like the oracle's curse, you'd get some rules-defined penalty and some rules-defined advantage. Perhaps the advantage accelerates over levels like the oracle's curse, but I suggest not doing that since it is so much harder to balance.

Another problem is that Type 1 diabetes is highly debilitating if not medicated properly and might just be too severe to allow adventuring. Some narrative freedom is needed to make this work. type 2 diabetes seems highly unlikely in a fit adventurer. I have type 2 diabetes (not severe) and the obesity that causes it has more consequences than the diabetes itself.

In 5E, I think backgrounds are the way to introduce something like this. I have made some backgrounds along these lines. I made something similar for invalids.

Invalid Background​

You suffer some handicap or ailment that has shaped your background. You have had to rely on the help of others until you learned to overcome most of your handicap. You might be eternally grateful to those who helped you grow up, or embittered at those who would not help you as much as you needed.
Skill Proficiencies: Insight, Perception.

Tool Proficiencies: Vehicles (land) and one musical instrument or set of tools.

Equipment: The aids or prosthetics listed to overcome your infirmity, traveler's clothes, one set of tools or a musical instrument, pouch with 15 gp.

Infirmity: You have a handicap that restricts your abilities in some way, but you have learnt to use prosthetics and skill to overcome most of your disability, allowing you to be an adventurer. Some infirmities even give you minor magical abilities. Select one Infirmity. The listed penalties assume you are using a simple prosthetic (such as a peg leg) when possible.

Infirmities​

Addicted​

You are addicted to a recreational drug like alcohol.

This is a cinematic adaptation of addiction. Don't push this to where it becomes uncomfortable and check with other players they are ok with this theme.

• You are able to function normally in combat and similar stressful situations. Whenever you are not in danger, you suffer the Poisoned condition, either from the effects of your addiction, or from withdrawal.
• Your addiction can be recognized with a Wisdom (Medicine) check against your passive Charisma (Deception). Any Charisma skill used against you that involves your addiction has advantage.
• Your addiction doubles your living expenses.
• The thing you are addicted to has no effect on you, and you are immune to further addiction of any kind.
• Your blood is mildly toxic. Creatures cannot drink your blood and you are immune to drugs, poison, and parasitic infection.

Blind Eye​

You are blind in one eye. Halve the range of any weapon or spell you use. You see invisible creatures and objects within 30 ft. as if they were visible.

Crippled Arms​

Your arms are severed or useless. You have trained your feet to overcome these limitations, when you are prone you can use your feet as if they were hands. You do not suffer disadvantage or give disadvantage on attack rolls when prone. You learn the Mage Hand cantrip and can cast it using your normal spellcasting ability. If you are not a spellcaster, use Dexterity as the spellcasting ability of your Mage Hand.

Deaf​

You permanently suffer the Deafened condition. You have learned to lip-read any language you know as long as you can see the speaker and is within 30 ft.

Hook Hand​

One of your hands is severed and has been replaced with a hook. You cannot wield a weapon in this hand or use a two-handed weapon, but you can do the following with the hook.

• You can satisfy the somatic components of spells and the hook hand counts as a spell focus for all classes.
• You can use the hook hand reload a one-handed weapon with the ammunition property held in your other hand.
• You can use the hook as melee weapon that does 1d4 slashing damage and has the finesse quality. You can use a bonus action to attack with your hook hand.
• You can make a Strength (Athletics) check to grapple as a bonus action.

Infested​

You carry a prodigious infestation of vermin such as worms, lice, and ticks. This infestation is obvious and disgusting, making others fear to be near you and barring you entrance to most civilized places. Any creature that ends their turn adjacent to you takes 1 poison damage. This damage increases to 1d4 at level 5, 1d8 at level 11, and 1d12 at level 17.

Lame​

Your legs are maimed or paralyzed. You need a wheelchair or similar conveyance to move around. Double the movement penalties for difficult ground. You suffer disadvantage on most Acrobatics and Athletics checks, as determined by the DM. Your steady position increases the range of any ranged attack or spell you use by half (+50%).

Leper​

This explores the consequences of prejudice. It should only be selected if all players are comfortable with it.

You suffer from some obvious and frightening medical condition that can never be cured. This need not be leprosy, it can be any horrid-looking ailment. This condition is not contagious or debilitating, but looks obviously unhealthy. Most NPCs have a hostile attitude to you and harass you or treat you as if you weren't there. They will not provide you services or lodging at any price. The hostile attitude only applies to you; your companions are not affected, and might even impress others by their benevolence in being willing to be around you. You gain proficiency in Survival and are immune to disease.

Limp​

You have a leg injury that reduces your land speed to 20 ft. This speed cannot be reduced by encumbrance or armor. You are immune to caltrops, Grease spells, and similar floor hazards.

Missing Leg​

You cannot walk without using a crutch, and even then your land speed is halved. If you do not constantly use one arm to hold yourself upright when standing, you fall prone. You have developed your upper-body muscles to compensate, gaining a +2 bonus to Strength.

Muffled​

You cannot speak in more than a whisper. You cannot make yourself understood to a creature more than 5 ft. away or be heard at all beyond 15 ft. This restricts your social interactions and the range of spells that require targets to hear you, but also makes it easy for you to cast spells without being noticed.

Paranoia​

You cannot use or benefit from the Help action. You are immune to the Charmed condition and are never surprised.

 

[Starfox]

Here is a literally 5-minute sketch for the infirmity of diabetes:
[Edit, worked it over just a bit]

Diabetic​

You suffer from diabetes. You need to keep a very strict diet consisting mainly of fat and lots and lots of water. You have to live at least a Modest lifestyle to afford this. Failure to do so prevents long rest and gives you a level of exhaustion each day. You tire easily, and gain a level of exhaustion for each full minute you keep up strenuous activity, such as combat. You can manage several shorter periods of hard work as long as you rest at least a minute between each. Your body greedily absorbs anything you ingest, which makes potions more efficient for you. Any potion that cures damage cures twice as much for you. Any potion with a duration lasts twice as long for you.

 

[Faolyn]

@Starfox, I gotta say, Invalid is a terrible word to use for this, as it's deeply insulting. Go with disabled, if you must.

I also guess that people with other types of handicaps would feel the same I do about having their handicap represented in the game. But others might feel proud and even empowered by being a hero despite their in-game handicap. Escapism means different things to different people.

Well, here's the thing. Blindness and deafness are already part of the game, as conditions that negatively affect the PC.

 

[Starfox]

@Starfox, I gotta say, Invalid is a terrible word to use for this, as it's deeply insulting. Go with disabled, if you must.



Well, here's the thing. Blindness and deafness are already part of the game, as conditions that negatively affect the PC.

English is not my native language, so it is easy to miss connotations. In Swedish, being an invalid (its spelled the same) means you live with injuries, often such suffered in the line of duty, and the connotation is quite positive. I think its the same in French, so I assumed it was so in English too.

 

[Starfox]

Looking for another term. "Disabled" to me means you are incapable of action, which is not really what you'd say about someone who is able to adventure. Same with crippled and incapacitated. Handicapped might work, it feels a bit too modern to my ear but is the best so far. I used "infirmity" to refer to the particular handicaps, but that is a word i made up for this and doesn't feel like a good name for a background.

The English language seems so abused, so many words and expressions chewed up and rendered unusable.

 

[MoonSong]

@Starfox, I gotta say, Invalid is a terrible word to use for this, as it's deeply insulting. Go with disabled, if you must.

It is a hard issue, due to euphemism threadmill. Any word chosen for this will eventually become a bad word, and be replaced by another well-intentioned word that in turn will become a bad word and be replaced by yet another one.

 

[Ulorian - Agent of Chaos]

English is not my native language, so it is easy to miss connotations. In Swedish, being an invalid (its spelled the same) means you live with injuries, often such suffered in the line of duty, and the connotation is quite positive. I think its the same in French, so I assumed it was so in English too.

Don't sweat it, invalid is fine. That's what the word means in English as well.

 

[MGibster]

The English language seems so abused, so many words and expressions chewed up and rendered unusable.

As Moonsong pointed out, it's the euphemism treadmill and it's just how English works. In the 1920s, the words moron, imbecile, and idiot were used to describe the mental capacity of various individuals. But over the years these words were commonly used as insults so we stopped using them as anything other than that. We're seeing the treadmill in action with TikTok videos where we see people using words like "unalive" instead of murder or suicide as a way to get around community standards.

Invalid is a fairly old fashioned word in that it's not one I see used very often. We don't typically refer to someone who is bedridden as being an invalid. I'm not sure it's actually insulting to anyone though.

 

[Krachek]

DnD don’t let space for such conditions because there are easy removal available.
DM need to cooperate and make such condition a part of his game.
It remind me of Elric of melnibone who was sick and need drugs to survive before he find stormbringer.
Having a sick hero is common in fanstasy, but it is easier to manage there.