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#EndDiabetesStigma: Using inclusive language for people living with diabetes

Edited: 17.04.2024

Johanah Co

HelloType1 Digital Learning and Development Manager, A4D

1. Tricky and judgmental labels

Each day can be tricky for people living with diabetes, and it can be hard for people who do not have the condition to understand how complex and challenging it is to manage. This is especially since there is a lot of misinformation as well as diabetes stigma to contend with. An important part of enabling people living with diabetes is using inclusive, non-judgmental, and encouraging language that helps build understanding, empathy, and a stigma-free environment. When we use labels like "compliant" or "non-adherent", these are unhelpful as they make a person living with diabetes feel guilty, fearful, and shameful.

A better way to approach this is to understand WHY they do what they do. As part of this, you might need to talk to them about their beliefs, fears, interests, and any issues that come up while you are planning their treatment. Only then can setting goals be realistic, workable, and sustainable. A two-way communication provides better outcomes and a more improved well-being for a person living with diabetes. It is best to use phrases like "manage" and "safe/unsafe" to focus on the individual's efforts and establish a non-judgmental context. Using adjectives like "bad," "control," and "adherence" can be judgmental and demotivating.

Telling a person living with diabetes, "Your diabetes control is bad, you are not adhering" may not be encouraging, instead, say "It may be unsafe for your long-term health if your blood glucose is not well managed."

2. Understanding diabetes stigma

When someone is judged, discriminated against, or treated badly because they have diabetes, this is called diabetes stigma. In some cases, this is caused by misinformation about diabetes, so educating other people can help. When someone has type 1, the body's immune system attacks the pancreatic islet cells that make insulin, which means the pancreas doesn't make any insulin. For those who have type 2 diabetes, the pancreas stops making as much insulin as it used to, and the body becomes resistant to insulin. Gestational diabetes is another type. This happens when your body doesn't make enough insulin while someone is pregnant. There is also Maturity-Onset Diabetes of the Young (MODY) which is a rare type of diabetes that is not the same as type 1 or type 2 diabetes. It tends to run strongly in families. Latent Autoimmune Diabetes of Adults (LADA), is an autoimmune condition that starts in adulthood and doesn't need insulin for at least six months after being diagnosed.

However, many people still have a lot of false beliefs and stereotypes. For example, they often mix up different types of diabetes or think that the person is to blame.

This diabetes stigma can hurt people living with diabetes emotionally and prevent them from talking about their condition. It may also cause people to hide their diabetes and may take less part in their diabetes care. How we talk about diabetes has a big impact on how people feel and think about their condition as well. As people who work in healthcare and/or as carers, creating an atmosphere that encourages understanding, positivity, and effective management may lead to better engagement and outcomes among them. People living with diabetes feel better about their mental health and well-being when you respect their thoughts, feelings, and challenges.

3. Educate yourself and avoid generalizations

It is important to learn about diabetes so that you can better understand and effectively support people who have it. One way is by finding out what people living with diabetes go through every day, including the medications and devices they need, and problems they may face. A lot of times, people misunderstand diabetes and think that all diabetes is the same. People who live with diabetes will have different experiences, so it's important not to generalize and dismiss those experiences.

Instead of saying, "Diabetics can't eat sugar," you may say, "people living with diabetes need to manage their carbohydrate intake, but they can still enjoy treats in moderation." By avoiding generalizations and paying attention to the human factor, they can feel more understood, empowered, and valued.

4. The Use of Person-First Language with Open-Ended Questions

Person-first language focuses on a person instead of their condition. Watch out when you say "a diabetic." If you want to be more respectful, it is more inclusive to say "a person living with diabetes." Others might not mind, but some might feel differently. This approach promotes the idea that a person's disease does not define them. This can help reduce diabetes stigma.

A great way to communicate with someone who has diabetes is to ask them open-ended questions about how they are feeling. Try asking, "How are you feeling today? Thank you for showing up. What has worked out for you lately?" instead of "Did you comply with the medication plan and control your diabetes with diet and exercise?" This method promotes open communication in an encouraging and strengths-based tone.

5. Acknowledge the Efforts and Lessen Unsolicited Advice

Taking care of diabetes takes constant effort and attention. People without diabetes can show support by recognizing the daily struggles and efforts that their friends or family with diabetes go through. You can really help them feel better by telling them things like, "I admire how hard you work to handle your diabetes" or "I know it's not easy, but you're doing a great job."

Refrain from offering tips for people living with diabetes when they have not asked for them. Many people who do not live with diabetes may mean well, but their statements can be hurtful and dismissive. Instead, offer your support and encouragement. If they ask for help, make sure you give them the correct advice and remind them that you are not a medical professional.

One way to help this cause is to support initiatives, policies, and laws that make sure everyone with diabetes is treated fairly. For example, you can pledge to www.enddiabetesstigma.org.

6. Inclusive and Strength-Based Language Makes a Big Difference

People who care for and support a loved one may be able to reduce diabetes stigma and make meaningful connections with people who have diabetes by using strength-based, inclusive, and supportive language. People living with diabetes are not meant to be judged, blamed, or shamed for having diabetes. It is not their fault. Instead, we can make society more accepting and understanding by learning about the diabetes condition, not making assumptions, speaking in a person-first way, and recognizing the efforts and progress of those living with diabetes. This change in language can make a big difference in their lives and help make the community more accepting and caring for everyone.

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