Best Practices for Patient-Centered
Language in Diabetes Care

At the Bermuda Diabetes Association, we know that it can be hard to live with diabetes and other chronic conditions.But no one should have to manage their health alone. Everyone can benefit from support and care from their friends, their family, the community at large and —especially — healthcare professionals.Sometimes, the language we use around diabetes might not be as supportive as we think. What we say to people with diabetes might not match what they hear or understand. It’s not just what we say or write: even non-verbal communication (like body language) can be interpreted and internalised. We all have a responsibility to make sure we know how our words and behaviour impact people’s ability to manage their conditions. This guide aims to offer person-oriented language that can help make it easier for people who have diabetes to live their best lives

Why does language matter?

Language directly affects our thoughts, feelings, behaviour and experiences. It can encourage or discourage us. When used positively, it can make people feel valued, supported and understood.But when used negatively, it can make them feel stigmatised, undermined and misunderstood.

For people living with diabetes, negative language can worsen diabetes-related distress and affect their general well-being. Stigmatising language can affect their motivation to engage, seek help or use medicines or technologies. This can lead to complications and worsen their condition.

How should I talk to people living with diabetes?

What to do

What not to do

Ask them how they want to be referred to. Makes ure you’re aligning with their preferences in your word choice.
Impart hope in your language choices.
Be person-centred, respectful, inclusive.
Use language that is easy to understand and accessible.
Help them see the process as collaborative and supportive.
Ask how they are feeling and thank them for sharing these feelings.
Acknowledge and validate their efforts in managing their health.
Recognise signs of diabetes distress.
Respond to words that imply shame or embarrassment.

Use language that judges, shames, demands orthreatens.
Use stereotypes or stigmatise.
Make assumptions about them.
Be disapproving or discriminating.
Blame them or anyone in their lives for thecondition.
Use binary/either-or language (good/bad,pass/fail, etc.).
Compare them to others with the condition (i.e.,“It could be worse,” or “If you don’t control it, you’ll end up like …”).
Provide your opinions as facts.
Talk about people with diabetes in a way that you wouldn’t with or in front of them.

How should I talk about diabetes?

Awareness is the first step to ensuring our language is helpful and not harmful. Below are a few commonly used terms that can have negative impacts, along with suggested alternatives.

By using these empathetic, empowering and person-oriented alternatives, you can help create a more supportive community environment for people living with diabetes.
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Try not to say…	Instead…
High-pressure words like… “Should”/ “Shouldn’t” “Can’t” “Must”/ “Must not” “Have to”	Use low pressure words like… ·"Consider” “Try” “Could” “Options”/ “Choices”
Negative descriptors like… "Diabetic” “Victim” “Patient” “Suffering from…”	Say: “Has not…” “Was not able to…” “This time didn’t…” "Lacked capacity or support to…”
“Disease”	Say “Condition”
“Obese”	Say “has excess weight,” or “has obesity”
“Compliant”/”noncompliant” “Adherent”/”nonadherent” Example: Jan is adhering to the recommended medication plan.	Use words that describe collaboration or specific behaviours. Jan checks her glucose levels regularly.
“Good/poor control” “Well/poorly controlled” Example: His blood sugar levels are good.	Try more concrete/specific language about what you’re referring to. Example: His blood sugar levels are stable/within target range.
“Fail”/ “Failing” Example: Monique is failing to control her diabetes.	Say… “Has not…” “Was not able to…” “This time didn’t…” "Lacked capacity or support to…” Example: Michael has diabetes.
“Correcting glucose levels”	Say “adjusting” or “optimizing”
“Test”	Say “monitor or check”
“Mild diabetes”/ Mild hypoglycaemia”	Say “diabetes,” “self-treated hypoglycaemia”
“Treating diabetes”	Say “managing diabetes”

Want to learn more about what to do and say to support people living with diabetes? Check out the resources on our website and consider becoming a Diabetes Anti-Stigma Ambassador.

Diabetes.bm should have the following resources listed on the site:

Diabetes Australia, Diabetes Canada andDiabetes U.K. have all put out excellentlanguage guides on this subject.
Dstigmatize is a wonderful resource thatnot only lists problematic terms and their alternatives but goes in-depth intothe rationale behind these alternatives. It also highlights when people mightprefer the “problematic” terms.
The Association of Diabetes Care and EducationSpecialists has a Language GuidanceTip Sheet that similarly covers problematic terms, preferredalternatives and the rationale behind each.

Best Practices for Patient-CenteredLanguage in Diabetes Care

Why does language matter?

How should I talk to people living with diabetes?

What to do

What not to do

How should I talk about diabetes?

Best Practices for Patient-Centered
Language in Diabetes Care