‘He Has Diabetes,’ Not ‘He Is Diabetic’: Why That Matters
Dec 21, 2020
Ashley Boarman
Diabetes Disease Management Tool

Diabetes care teams are talking differently these days. That’s because the effect language has on patient care and patient outcomes can be profound, physicians have discovered.

As our U.S. healthcare system moves toward a more patient-centered approach, it’s necessary for providers to reexamine their words, says endocrinologist Melissa Weinberg, M.D., of Sutter Pacific Medical Foundation and lead physician of Sutter’s Diabetes Clinical Improvement Community.

“When we started looking at diabetes care through a linguistic lens, we found unintended judgmental language across chart notes, patient education handouts, and even in our conversations,” Weinberg said. “Our teams are working on using person-first language whenever possible.”

Talking the Talk

“Person-first language” puts a person before their diagnosis, describing what a person “has” rather than asserting what a person “is.”

“Despite even the best intentions, words can result in patients feeling like they are their diagnosis,” says Michelle Bradley, an exercise physiologist with Palo Alto Medical Foundation, who also serves on Sutter’s DCIC.

Referring to a patient as “diabetic,” such as “a person who is diabetic,” can reinforce that as their identity. Rather, Bradley says, it would be better to say “a person with diabetes,” which puts the patient first and shows compassionate and encouraging language that may help enhance their outcomes and experience.

Stigma around certain language can impact care. According to two different studies (located here and here), possibly because of perceived judgment from healthcare professionals, people with diabetes who identify as being diabetics sometimes altered or underreported blood glucose levels or omitted information during provider visits.

Neutral Language Helps Remove Stigma

While a language movement in healthcare isn’t a new concept, there is greater emphasis to use language that empowers and supports. Here are four examples of phrases that Sutter diabetes care teams are working to incorporate in patient communications:

  • Monitoring blood sugar/glucose” instead of “testing blood sugar/glucose”
  • A person who …” takes medication irregularly, is unable to access supplies, or continues to eat ice cream before bed, instead of labeling them “non-compliant, non-adherent, unwilling”
  • Managing, working toward …” instead of “controlled, uncontrolled, sub-optimal”
  • Guidelines or Recommendations are …” instead of “you should, have to, need to, must”

“The way we speak affects the way we think and ultimately how patients feel,” says Dr. Weinberg.

More Than Their Diagnosis

Sutter Health is committed to improving healthcare outcomes for all, and communication with and about patients has been proven to be a factor in better outcomes.

“When we change our language, we change the perception,” says Bradley. “Simple wording changes can go a long way in helping to build and strengthen patient relationships,” 

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