By fostering a language of support, empathy, and clarity, we can contribute to a more positive and effective diabetes experience for everyone involved. Kate Bristow expands on this.
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“Words stick in our minds and our hearts.”
Remember the saying, “Sticks and stones may break my bones, but words will never hurt me?” We were taught this growing up and we believed it – it made us brave – or did it?
We were not taught that words do damage, often deeper and for longer. Sticks and stones do hurt, for sure. They leave scars, sometimes big ones and the wound left can be cared for and treated because we can see it.
The trouble with words is that they leave no visible scar, nothing to show for the hurt caused. Words dig deep inside of us and can whisper back to us over time eroding confidence and extending the hurt. Words stick in our minds and our hearts.
How does this relate to diabetes?
Diabetes Australia has this to say about the language of diabetes, “Our language matters. The words we choose, and the way we use them, influence, persuade and affect how people view the world. Words do more than reflect reality: they create reality.”
Words make people feel valued, understood, and supported but they can also show bias, whether it be conscious or unconscious.
Sometimes we don’t realise the effect that our words and how we say things have on people. Language is crucial in shaping perception, our behaviour, and health outcomes. Diabetes management is no exception.
Diabetes management is a multi-faceted journey involving medical, lifestyle, and emotional components. One often overlooked yet profoundly impactful aspect of this journey is language. The way we talk about diabetes—whether in clinical settings, personal conversations, or public discourse—can significantly influence outcomes, attitudes, and overall quality of life for people living with the condition.
The International Diabetes Federation (IDF) as well as other diabetes organisations around the world have started the #LanguageMatters movement, encouraging us to think about how we communicate with people, and specifically with people with diabetes.
Let’s dig deeper
How we approach what we say affects those of us in healthcare as well as those who have diabetes. Language shapes how people understand and manage their condition. Terms and phrases used by healthcare professionals, support networks, and even the person with diabetes (PWD) themselves, can impact self-perception and emotional well-being.
For example, labelling diabetes as a “battle” or a “struggle” might contribute to a feeling of constant conflict, potentially leading to burnout and frustration. Conversely, framing it as a “journey” or “part of life” might foster a more positive and resilient mindset.
We (the public and healthcare) put stigma into our interpretation of the challenges faced by those with diabetes. For example, “Diabetes is a result of poor lifestyle choices” or “just control your sugar” can also lead to feelings of shame and guilt. Comments like this show lack of understanding of the complex condition which is diabetes, and how genetics, environment, and other aspects of life may influence diabetes.
Unfortunately, comments like this will affect a person’s self-esteem and discourage them from asking for help, or perhaps even sticking to a treatment plan.
As a diabetes educator I’ve often heard, “I got diabetes from eating too much sugar” or “He got diabetes because he eats too much.” We need to change the mindset in the public space and take away stigma and blame; it’s destructive and doesn’t help someone who is coming to terms with and trying to manage a chronic condition.
Supportive and empathetic approach
In healthcare, we need to have a supportive and empathetic approach to increase trust and engagement in the process. For example, managing diabetes as opposed to controlling diabetes gives a better sense of teamwork and partnership instead of an approach which is strict or punitive.
Be aware of body language, tone, and attitude
It’s also not just about the words we use, but our body language, tone, and attitude. A good example for body language is sitting behind a desk which gives a position of authority and control. This may be intimidating for the person with diabetes, especially a child or young person. A better approach may be to remove the barrier completely and create the impression of a safe space. Our whole persona needs to be non-judgemental and welcoming.
Avoid medical jargon
If we look at our diabetes definitions, often those of us in healthcare use medical terminology, such as hyperglycaemia and insulin resistance versus high blood glucose and difficulty in managing diabetes. Effective education for people with diabetes relies on clear and accessible language. Medical jargon can be confusing, leading to misunderstandings and less compliance with treatment.
Simplification of medical terms and providing clear, easy language will help people understand their condition and the steps they need to take for better self-management.
Think also about the word testing – I test, I’m testing, I’m being tested – it sounds like an exam or something to stress about. Replace that with the word check – how different does that feel?
Choose a positive approach
Diabetes burnout is real, and people with diabetes have so much to manage their condition already. All of us involved in their lives (healthcare team, family and friends) need to try to choose our words to impact them in a positive and encouraging manner to reduce diabetes distress.
Diabetes Australia suggest that we change the conversation around diabetes – be aware of how you say things and how they may be interpreted and approach every interaction consciously and without any bias. We are encouraged to challenge inappropriate words and change the thinking. Words have power and although it may take time for habits to change, it’s not rocket science. We just need to practise the new language of diabetes.
Words need to be:
- Curious – Show care and interest in how the person is doing.
- Be accurate – Use plain language that encourages change without judgement.
- Be respectful – Provide information in a way that the person can understand with respect for cultural practices and values.
- Acknowledge that they are doing the best they can.
- Empathic – Show understanding of the person and their circumstances.
Words need to take away:
- Blame – Prevents a person from doing their best or accessing care for fear of blame or shame.
- Irreverence – Using diabetes as a punchline in jokes is offensive and insensitive and shows lack of respect.
- Authority – Words such as should, must or allowed aren’t going to make people change. Instead, they make the person with diabetes feel like they are failing.
- Stigma – People with diabetes often feel judged, criticised and misunderstood so they hide their condition and how they manage it. This is negative from an emotional and physical perspective.
A few examples of how we as carers, family, and friends of someone can change our language.
| Possible negative connotations | Suggested better choices |
| Compliant, non-compliant, non-adherent | Takes this medication about half the time |
| Diabetic, sufferer, patient | Person with diabetes, person living with diabetes |
| I want you to | Can I suggest |
| Refused | Declined |
| Cheating, sneaking, good, bad, poor | Making choices or decisions |
| Test, test blood glucose, test strips | Check, check blood glucose, glucose strips |
| Disease | Chronic condition |
| In denial, difficult patient | Finding it difficult, has concerns about |
| Failed to, failure on treatment | Did not, has not, does not |
| Should not, can’t, have to, must not | You could try, let’s consider your options, you could choose to |
Survey results
A 2019 survey found that the following words were deemed negative to many people with diabetes. The % of PWD found these words unacceptable.
- Victim – 99%
- Sufferer – 96%
- Consumer – 95%
- Normal – 84%
- Cheating – 95%
- Uncontrolled – 75%
Language is more than just a means of communication; it’s a powerful tool that shapes our understanding, emotions, and actions. In the context of diabetes, choosing words carefully can make a profound difference in outcomes, emotional well-being, and the overall management of the condition. By fostering a language of support, empathy, and clarity, we can contribute to a more positive and effective diabetes experience for everyone involved.
I found a lovely article about the damage words can do and I loved the conclusion they wrote: “And so tread carefully with the words you speak on others. You know not the damage you cause. Speak only good things into the universe. About yourself and about others.”
We need to choose our words with care, however we are involved with a person living with diabetes.
“Be sure to taste your words before you spit them out.”
References
https://anonymouslyafroirish.wordpress.com/2019/04/17/sticks-and-stones-
https://www.england.nhs.uk/long-read/language-matters-language-and-diabetes
MEET THE EXPERT
Kate Bristow is a qualified nursing sister and certified diabetes educator. She currently runs a Centre for Diabetes from rooms in Pietermaritzburg, providing the network support required for the patients who are members on the diabetes management programme. She also helps patients who are not affiliated to a diabetes management programme on a private individual consultation basis, providing on-going assistance and education to assist them with their self-management of their diabetes.
Header image by FreePik