Word Choice Matters in Diabetes Care

A noted certified diabetes educator describes why we need to move toward language that celebrates the strengths of people with diabetes instead of their weaknesses.

Language can create hope or take it away. When someone calls you or child “non-compliant” or writes “uncontrolled” on your chart, it may have a real impact on your well-being. This kind of language needs to be phased out for the well-being of all.

“Compliance” and “adherence” are words that come from an acute care model, one in which people simply do what health care professionals tell them to do. That model is outdated and unhelpful in diabetes management, and so are these words. Those of us working toward effective patient-provider relationships are also working toward changing the language of how we speak about diabetes. We are striving to use words that empower people to live well with diabetes through daily self-management decisions and actions. The recent joint paper published by the American Association of Diabetes Educators and the American Diabetes Association includes recommendations to use “strengths-based language,” which focuses on what people are doing and builds on that, rather than language that focuses on deficits or weaknesses.

In my focus group study on language, participants shared that if health care providers changed the way they talk about diabetes, as well as how they talk to people living with diabetes, it would build trust and empower people to take care for themselves. People are more likely to take care of themselves if they feel good about themselves; the messaging used by health care providers, right down to the word choice, can help.

You don’t have to wait for this shift in language to trickle down to your health care provider; you can start practicing using strengths-based language in your own life.

Here are some suggestions:

-Pay attention to the language you use to discuss diabetes and to describe yourself.

-Use language that fosters hope inside of you.

-Consider using empowering and strengths-based language, replacing “I can’t” with “I don’t” and “I have to” with “I choose to,” for example.

-Think about the words that perpetuate stigma for you. Share them with others and explain your reasoning for not to use them.

Choose carefully the language you wish to use to talk about diabetes. After all, there’s power – and hope – in words.

-Jane K. Dickinson, RN, PhD, CDE

Jane has been living with type 1 diabetes since 1975, and helping others live well with diabetes since 1995. Jane is the Program Director and faculty for the online Master of Science in Diabetes Education and Management program at Teachers College Columbia University. 

Photo caption: The author, speaking at a T1D Exchange conference to improve quality of Type 1 Diabetes treatment. Photo by Ezra Ekman / ShotInTheAct.com.


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