ABCs of Language Use in Diabetes

The Words We Choose – ABC’s of a more thoughtful approach

The term “diabetic” is officially off-limits.

Say goodbye the phrase “you can control your diabetes’.

Ditch characterizing people with diabetes as unmotivated or non adherent.

Retire the word patient and replace with the term participant.

Let go of the term “test” blood sugar and replace with the term “check”.

A recent article, The Use of Language in Diabetes Care and Education (AADE, ADA 2017), reminds us that language we chose when coaching people with diabetes is powerful and can have a lasting impact on perceptions as well as behavior.


As a diabetes educator for over twenty years, I have witnessed the pain and shame of countless people living with diabetes. At our first meeting, they sit down with head hanging low and an air of defeat.

They might say something like, “My provider told me if I didn’t get my blood sugars down, they would have to start me on insulin.”  Or something like, “My blood sugars are out of control and it’s all my fault.”  Where is this message of self-failure coming from and how can we change the paradigm?

In society and in the health care field, the The Use of Language in Diabetes Care and Education (AADE, ADA 2017), shapes the way a person with diabetes sees themselves. “Language lies at the core of attitude change, social perception, personal identity and stereotyping.  Words are immediately shaped into meaning, and those meanings affect how a person views themselves.”

As educators, advocates, spouses, friends, and providers, our use of language can deeply affect the self-view of people living with diabetes everyday.

Let’s lift people up with the language we choose.

Let’s demonstrate through our body language and questions that we believe in their abilities.

Let’s recognize that diabetes isn’t about being perfect, it’s about creating realistic expectations that consider the person’s current life situation.

This article is designed to highlight some small changes in word use and language that can make a big difference in the lives of those with diabetes. 

Before we get started, you might want to

Test your Diabetes Language IQ with this short
4 question Quiz.

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During that first sit down meeting, we listen carefully to the story, to find out what is working with their diabetes and what barriers might be getting in the way. The words we use in this encounter sets the stage for our ongoing working relationship and will influence the self-perception of the person sitting across from us.

Language change starts here:

Use “person-first” language that indicates awareness and dignity while placing emphasis on the person rather than the condition/disease.

Example: “Your doctor referred you to our program to help you manage your diabetes” (instead of “Your doctor referred you to our program because you are a diabetic”).

Focus on using neutral words and physiology instead of words that cast shame and blame. Avoid using the phrase “control” diabetes. In truth, control is virtually impossible to achieve in a disease where the pancreas is broken. Despite best efforts, blood sugars may be above or below target at any given moment.

Example: “Your A1c of 9.8% is above the target of 7%.” (instead of, “Your A1c is really high.”)

Example:  “Exercise can help you manage your blood sugar levels.” (instead of, “You can control your diabetes by exercising and eating right.”)

Barriers 


Barriers to self-care can often be misinterpreted as non-compliance or non-adherence. It’s time to ditch these terms and focus on the self-care behaviors the person with diabetes is doing. We can focus on facts rather than judgments.

Example: “MJ hasn’t started taking her insulin because she is worried about weight gain and hypoglycemia.” (instead of, “MJ is non-compliant and is refusing to take her insulin.”)

As we explore their self-care habits, we can use language that is non-judgmental, strengths based and collaborative.

Let’s give the person with diabetes credit for what they are accomplishing and let’s avoid taking credit for their behavior changes.

Example: “It looks like you are checking your blood sugar about 3 times a week?” (instead of “You are only checking your blood sugar 3 times a week?”)

Compassion

A new study highlights how compassion plays a significant role in our clinical practice.

According to a HealthTap survey, patients and physicians alike rate the role of compassion as most important. 

Below are the fours findings from the HealthTap Survey.

“1. When making a healthcare decision, 85 percent of patients said compassion was very important to them, while only 31 percent of patients said cost was very important.

2. Although wait time to see a medical provider is often considered a barrier to patients’ happiness, only 48 percent of patients cited it as a very important factor in healthcare satisfaction.

3. Eighty-nine percent of physicians cited compassion as a very important part of delivering the best care, which was higher than the importance physicians placed on education and command of medical knowledge (86 percent).

4. Nearly all — 94 percent — of physicians said being compassionate makes their patients more likely to follow their advice, which can significantly improve patients’ health outcomes.”

Read more about this here >>  

Thoughtful language use and compassion can contribute to improved self-care, collaboration and improved quality of life. Thank you for being change agents and advocating for a person-first approach for those living with diabetes.