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ASL and Equitable Diabetes Care

Author: Christine Craig, MS, RDN, CDCES
Founder: Nutrition for Daily Living

Did you know that people with diabetes are more likely to experience hearing loss?
At the June 2026 American Diabetes Association Scientific Sessions, Dr. Michelle Litchman presented a new American Sign Language (ASL)
1-based DSMES resource for individuals who are deaf and hard-of-hearing.

DeafDiabetesCan.org was created to ensure that DSMES content is delivered in a linguistically appropriate format.

Link Between Hearing Loss and Diabetes

In the US, about 11 million people are deaf or hard-of-hearing and experience diabetes at much higher rates than hearing populations. They are 3.2 times more likely to be diagnosed with diabetes and 1.6 times more likely to be at risk.3 Additionally, people with diabetes are more likely to experience hearing loss, and in some cases, diabetes and deafness co-occur due to genetic conditions. A lack of accessible health information and diabetes education in ASL is a key equity barrier, and about half of healthcare encounters occur without a qualified ASL interpreter.3 As a result, traditional DSMES approaches may not fully support understanding, engagement, or sustained behavior change, causing disparities in care.

Increasing ASL Access to People with Diabetes

DeafDiabetesCan.org was developed jointly by University of Utah researchers and a Community Advisory Board, with both groups collaborating throughout planning, content creation and review. Its goal is to provide diabetes education in ASL (supported by English captions and voiceover) to enhance accessibility for a range of users. Current content includes a diabetes ASL dictionary, evidence-based educational videos aligned with basic principles of diabetes care, and DSMES topics including glucose monitoring, nutrition, medications, and ongoing support for daily self-care behaviors. A link to find ASL interpreters is also available. In addition, tips for both persons living with deafness and diabetes and the clinician are available.

Getting the word out about Equitable Care

As diabetes care and education specialists, we can be aware of and implement recommendations to ensure equitable care. DeafDiabetesCan.org reminds us that if a person requests an ASL interpreter, clinics are legally required under the Americans with Disabilities Act to provide one2 and because ASL is a distinct language and not visual English, written materials alone may not be sufficient. Suggested best practices include scheduling qualified interpreters at the time of appointment booking, allowing additional visit time, and requesting interpreters who are familiar with medical terminology.2 We can also create a supportive environment so the person living with diabetes can clearly see the interpreter, while we, just as with other translations, communicate directly with the person using teach-back strategies to ensure understanding and engagement.2
The ADA Standards of Care emphasize that DSMES should be individualized and person-centered, addressing each person’s language, culture, literacy, and communication needs.4 Knowledge of available tools and incorporating accessible educational resources into routine practice ensures all individuals can fully participate in and benefit from DSMES and equitable diabetes care.

Christine Craig, MS, RDN, CDCES
Founder: Nutrition for Daily Living

References:

  1. National Institute on Deafness and Other Communication Disorders (NIDCD). American Sign Language. National Institutes of Health. Accessed June 19, 2026. https://www.nidcd.nih.gov/health/american-sign-language
  2. University of Utah Health. First diabetes website in ASL launches. @theU. Published January 14, 2026. Accessed June 19, 2026. https://attheu.utah.edu/facultystaff/first-diabetes-website-in-asl-launches/
  3. Hughes AS, Mirus K, Heydarian NM, Litchman ML. Diabetes Care Disparities in Deaf/Hard of Hearing and Blind/Low Vision Populations. Curr Diab Rep. 2024 Dec 30;25(1):14. doi: 10.1007/s11892-024-01565-z.
  4. American Diabetes Association Professional Practice Committee for Diabetes*; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026. Diabetes Care 1 January 2026; 49 (Supplement_1): S89–S131. https://doi.org/10.2337/dc26-S005

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