Diabetic- the word that makes me cringe. When I see it in chart notes, I want to shake the author and say “Haven’t you read the Language in Diabetes article? Have you been living under a rock?? We don’t say that anymore! It is in the 2016 Standards of Care that we don’t use that word for crying out loud!” When I hear a medical professional refer to their patients as “diabetic” I have a similar visceral response. Why is my response to this word so strong? I think it may come from my time growing up as the only little kid in my school with diabetes. I was Jessica Kirk- “the diabetic.“ Having diabetes made me feel different. Being called “diabetic” made me feel even more different.
I have read numerous online forums where people living with diabetes debate the word. I have seen some cite “political correctness” behind the movement to get rid of the word and proudly refer to themselves as a diabetic, while others express negative feelings like I do about the word. In 2016, the American Diabetes Association urged clinicians to not use the word in the Standards of Medical Care in Diabetes. In 2017, the ADA and AADE published a joint paper on “Language in Diabetes Care and Education” that not only discourage use of the word, but introduced a laundry list of words that are common in diabetes care from which we should refrain.
Whatever your feelings may be on the word “diabetic,” it is our responsibility as educators and leaders in the diabetes field to know the recommendations on language in diabetes and practice them. Our practice is based on evidence. The medical standards of care and consensus statements made by ADA and AADE are based on evidence. There is evidence to support these language changes- read it, know it, practice it.
The words we use, and the connotations associated with these words matter. Our words impact the feelings our patients have about their diabetes. Calling blood glucose monitoring “testing” implies it is a test that can be passed or failed. Who wants to take a test they will fail? And we wonder why our patients do not monitor as frequently as we suggest. Calling someone’s diabetes “controlled” or “uncontrolled” implies the person has 100% control over the outcomes. We all know that is not possible. There are many variables in diabetes that we and our patients have no control over, yet we nonchalantly toss around words that set our patients up for failure. Referring to someone as “diabetic” focuses on the disease and not on the person. It may seem trite but for some people it makes an impact. I am one of those people. Read the article and encourage your colleagues to read the article. Change starts here.
By Jessica Kirk MSN, RN, CPN, CDE