Living with diabetes is hard. The way people who don’t have diabetes talk about it can make it even harder. Language matters when it comes to talking about diabetes. Here are 5 common things we hear said and what to say instead.
Perspective From a “Diabetic”
As someone who has lived with diabetes for over 25 years I’ve heard a lot of myths, stigma, and mischaracterizations about the disease. And it was about 15 years into living with diabetes that I first realized the toll that language had taken on not only my own diabetes management, but that of so many people I’ve met since then.
Diabetes management is a 24/7 task. Someone with diabetes has to think about it in all aspects of life. It affects everything. The foods you choose to eat. What time you choose to eat. Even whether you choose to eat.
Diabetes complicates or is complicated by sleep, exercise, stress, mental health, physical health, social health, sexual health, psychological health…really anything in life is tied into managing diabetes.
If you have diabetes, you know what I’m talking about. If you do not have diabetes, imagine how difficult it might be to hear that it is your own personal failing, or “you could cure your diabetes if you’d just _____,” or to be reduced to your disease. These are real things that many of us hear often.
American Diabetes Association Guidelines
When it comes to diabetes care and education, the American Diabetes Association (ADA) has laid out some good reasoning for why language matters around diabetes, starting with how “language is powerful and can have a strong impact on perceptions as well as behavior.”
Let’s just clear the air. There are several problematic statements that I hear often as someone with diabetes. And Diathrive Health is committed to getting them right to not just show respect to the people we serve, but to help fight the diabetes stigma that such language often perpetuates.
5 Things You Might Be Saying and What to Say Instead
While there are far more, let’s take a closer look at the top 5 problematic statements I hear, what to say instead, and most importantly, why.
1- Diabetics
It may not have even occurred to you. We’ve all been saying diabetic for years! But diabetic is bad language to use when referring to someone living with it.
What to say instead - people with diabetes / people living with diabetes. For example, refer to those on your health plan as a “population with diabetes” instead of “diabetic population.”
Why? “Diabetic” reduces someone to their disease first. Person-first language is empathetic.
2- Compliant or adherent
Doctors love these words. Afterall, doctors are smart. They generally have a good grasp on what a patient should be doing to reach better health. And when a patient doesn’t achieve those desired health outcomes, the individual with diabetes is often labeled as “non-compliant” or “non-adherent.
What to say instead - Engagement.
Why? “Compliant/adherent” is judgmental. When I inevitably don’t follow the doctor’s outline exactly, I feel as if I’ve failed. It causes burnout and demotivation.
Life isn’t as simple as “just follow the doctor’s orders.” 95% of life with diabetes is self-management. We have to take the doctor’s recommendation home with us and do our best to manage our disease while also living our life! My ability to engage with my health varies hour- to-hour, day-to-day and week-to-week. Highlighting what someone does well, and the positive result, can help inspire them to continue on the path to better engagement.
3- Control
What to say instead - Manage.
Why? I’m sorry, but you can’t “control” diabetes. Even if we are doing everything seemingly right and see no symptoms, something can blow it all up instantly. And whether or not that happens, it means the same thing: we’ve “managed” diabetes the best we can.
4- Cure or reverse
What to say instead - Remission.
Why? This terminology mostly refers to type 2 diabetes. In case you don’t already know, there is 0% chance to cure or reverse type 1 diabetes, or even put it into remission.
Diabetes cannot be cured. “Reversal” is often used interchangeably with “cure” as it implies diabetes has gone away. When “reversal” refers to bringing blood sugar back to the range of someone who does not have diabetes, some level of clinical support will normally be needed. That’s remission. Since diabetes cannot actually be cured, it still lurks in the background just waiting for a mistake or physiological change.
5- Sugar causes diabetes
What to say instead - Sugar increases health risks.
Why? Sugar consumption will not give you a disease. Over-consumption can definitely raise risks.
Because diabetes is about glucose levels (blood sugar) people like to make seemingly harmless jokes about how “these donuts are going to give us diabetes!” But for those of us who actually have diabetes, it’s insulting.
This is a classic piece of diabetes stigma that tells people with diabetes that you think they did this to themselves. They could “cure” their diabetes if they’d just stop eating sugar. It fails to acknowledge the role that genetics, socioeconomic status, food security, and psychosocial factors play in a type 2 diabetes diagnosis. And it fails to recognize that type 1 diabetes is purely an auto-immune disorder that has exactly zero to do with risks associated with eating sugar.
Why You Should Care
As time marches on, the effects that language has on people has become better understood. One could argue that knowing how words motivate or demotivate a person should put some responsibility on us all to the more mindful. Think about the individual. This person living with diabetes needs care and support from the world around them. Being thoughtful and empathetic is a good practice for all of us.
Diathrive Health treats members with empathy and dignity. We are focused on positive health outcomes by addressing the psychosocial determinants that hold people back from achieving them.
Find out how unlimited tools and individualized care from credentialed clinicians can help your population with diabetes engage with their health in a new and meaningful way while saving your plan up to 80% on diabetes spend.
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About Chris Clement:
Chris Clement (Clem) is social media manager and content director at Diathrive. He has lived with type 1 diabetes since 1997.