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Diabetes as a Disadvantage

There are two types of Diabetes: Type I and Type II. Basically (and this is, of course, oversimplified for gameability), Type I is genetic and means that you require insulin. Type II is brought on by other diseases or being overweight and means that you need to watch your diet by avoiding carbohydrates and fats.

Despite what many have suggested in the past, Type I Diabetes cannot be modeled with Dependency (Insulin). A Type I who goes without his insulin does not suffer damage. Instead, his body cannot process the food he consumes and becomes run down and weakened. Eventually, he will die of starvation. In GURPS, this is best modeled with Restricted Diet -- a Type I must "consume" insulin with every meal to properly metabolize the food. If necessary, he can eat without it, but the resulting high blood sugar is hard on one's body and may cause a temporary reduction to HT. The Substitution limitation covers this well, but it's a little too lenient; it would allow a Type I to go off insulin forever if he kept making his HT rolls. So a variant is necessary:

Special Limitation for Restricted Diet
Partial Substitution: Like Substitution, but if you substitute all of your meals for the day, you still suffer starvation as though you had missed one meal, regardless of your HT rolls. -30%

A Type II who goes off of his diet doesn't begin to starve, but may suffer the effects of reduced HT due to high blood sugar just like a Type I diabetic does. Restricted Diet can model this as-is with the normal Substitution modifier. In either case (Type I or II), the temporary HT losses can be recovered at the rate of 1 HT for each day spent resting, eating properly, and taking insulin if Type I.

Long-Term Effects of Diabetes: For every month in which a diabetic substitutes more than half of his meals, he accumulates -1 character point towards lowering his HT. If he's between -1 and -9 accumulated points at the moment, eating right for every meal for one full month will remove one -1 point; however once a level of HT is lost, it's lost for good. Given the gradual nature of this complication and the fact that it's not much of a threat in game terms compared to the immediate disadvantages, it can be treated as a physical Quirk.

Summing up, that gives us...

Diabetic: -6 or -15 points

Type I: Restricted Diet (Common: Insulin with meals; Partial Substitution, -30%) [-14]; Repeated substution can cause reduced HT [-1]. -15 points.

Type II: Restricted Diet (Very Common: Low-carbohydrate, low-fat foods; Substitution, -50%) [-5]; Repeated substution can cause reduced HT [-1]. -6 points.

Either type of diabetic may also require "diabetic medication", which is not insulin, but pills which help the body process sugars. For game purposes, this does not affect the value of the disadvantages above; the need to take an inexpensive pill with one's meal is overshadowed by the need to carry and use a diabetic kit (glucometer, syringes, and insulin) or to severely restrict one's diet. To build a Type II diabetic who doesn't have to watch his diet as long as he takes the pill, use the Mitigator limitation:

Diabetic (Type II, Mild): As long as you take a pill with your meal, you can eat what you want, within reason. Diabetes (Type II; Mitigator, Daily Drug, -60%) [-2]. -2 points.

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