When I was writing a blog about diabetes, a grammar app advised me not to use the term “diabetic” since it would offend some people. I have only known the term “diabetic” since my diagnosis at seven years old, when people called it juvenile diabetes instead of type 1 diabetes, as they do now. For the first time, I realized some people would find it insulting, and my research as to why was eye-opening.
The reason for the movement to use “person with diabetes” instead of “diabetic” is that some argue that “diabetic” is an offensive term because diabetes is not something you are, but something you have. On the flip side, others argue that we are being too sensitive and politically correct.
However, research reveals that calling a person diabetic may not just offend them; it may also make their diabetes worse. For example, negative words can trigger a stress response and release hormones (corticosteroids) that can lead to elevated blood glucose levels and inflammation.
The article, “Commentary: The Effect of Words on Health and Diabetes,” by Jane K. Dickinson, discusses the effects language used by healthcare professionals can have on health and diabetes management. The research found that negative or judgmental language can contribute to “diabetes distress” (fears associated with managing the disease), which is linked to diminished self-care and elevated A1C levels.
The argument is not just for the word “diabetic” but also for other words that describe diabetes management, such as “compliant,” “control,” and “fail,” because they describe the person and not the behavior.
The concern is that using these terms is:
Other words like “adherence,” “correction,” and “good” or “bad” can also imply judgment or blame. They suggest using manage instead of control. Also recommended is using the words safe/unsafe vs. good/bad.
According to the National Institute of Health,“Person-first language is a way to emphasize the person and view the disorder, disease, condition, or disability as only one part of the whole person. Describe what the person “has” rather than what the person “is.” Person-first language avoids using labels or adjectives to define someone, e.g., a person with diabetes not a diabetic; or a person with cancer not cancer patient; or a person with bipolar disorder not a person who is bipolar.”
Here is a guide from the Association of Diabetes Care & Education Specialists (ADCES) on speaking the language of diabetes with preferred language and reasons for recommendations.
If you think about it, this is not a new concept, as there are outdated terms for patient descriptions, such as “lunatic,” “insane,” and “crazy” for those with serious mental illness. People no longer use “mental retardation” but use intellectual disability. Similarly, people now consider the terms “crippled” or “handicapped” offensive, and they prefer to say “a person with a disability” instead.
The movement reminded me of a video that stated people with diseases should never give possession to their disease and use language like “my cancer, or my illness.” The reasons are that possessive language can have negative psychological effects, lead to internalized stigma and shame, define a person by their illness, and even imply that the individual is at fault for having the condition.
As a child, I remember being told that words can hurt, and it reminds me of this. Because I’ve had this disease for so long and have heard it nearly my entire life, I don’t mind calling myself or being called “a diabetic.” But I want to be mindful and sensitive because some may not feel the same way I do. And the articles have given me many things to consider, such as not saying it’s “my diabetes” and being more aware of how words like “out of control” or “bad numbers” can influence a person’s self-worth and emotions when describing diabetes management.
“Don’t use the language of ‘good’ or ‘bad’ when talking about blood sugar numbers – these are data points, not judgment of your ability to manage diabetes” – Adam Brown
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