TABLE 1.

Suggestions for Improving Messages in Diabetes

Instead ofUseRationale
When referring to people with diabetes
Diabetic• Person with diabetes
• Person living with diabetes
• Person who has diabetes
• Put the person first
• Thinking of a person as having rather than being is empowering.
When talking about weight
Obese/fat• Unhealthy weight
• Extra weight
• Has obesity
• Avoid words that send messages of stigma and blame.
Normal weight• Healthy weight
• Goal weight
• In general, it is best to avoid the word “normal” because its opposite, “abnormal,” is scary. Use more descriptive terms.
When talking about blood glucose levels
Normal blood glucose• Target blood glucose
• Goal blood glucose
• Strengths-based; send messages about what is realistic and achievable.
Control
Controlled
Uncontrolled
Good/bad control
Poor control
Poorly controlled
Metabolic control
Glycemic control
Control diabetes
• Blood glucose levels
• Elevated/high blood glucose level
• A1C
• Glucose variability
• Glucose stability/instability
• Target glucose levels
• Glycemic targets
• Glycemic goals
• Manage diabetes
• Focus on physiology, and avoid judgment.
• True “control” is virtually impossible to achieve.
When talking about treatments or self-care behaviors
Failed• Did not/has not/does not . . .
• The medication/intervention failed to work for the person.
• People do not fail, their medications or treatments do.
Should• Can I make a suggestion?
• Have you considered . . .
• Well-intentioned suggestions of what “should” be done can make one feel burdened, overwhelmed, and shameful.
Get them to . . . (as in, “I got him to lose 50 pounds” or “I got her to take insulin.”)• Help
• Work with
• Partner
• Collaborate
• “He lost 50 pounds.”
• “She started taking insulin.”
• Give people credit for the work their doing.
Blood glucose testing• Blood glucose monitoring
• Checking blood glucose levels
• “Test” implies pass/fail or good/bad. Use words that imply collecting information (numbers) with which to make decisions.
Normal blood glucose• Target blood glucose
• Blood glucose goal(s)
• In general, it is best to avoid the word “normal” because its opposite, “abnormal,” is scary. Use more descriptive terms.
Diet• Meal plan
• Food choices
• Eating plan
• People often have negative associations of “diets” that are short term and usually have not worked.
Exercise• Physical activity• “Exercise” often brings up negative images of something difficult and outside of most people’s usual routines, whereas “physical activity” seems more attainable.
Adherence/compliance• Medication taking
• Takes/does not take care of himself/herself
• She takes her medication about half the time.
• He takes his insulin when he can afford it.
• Focus on behaviors and physiology.
• Avoid words that send messages of judgment.
• Frame statements in a positive way; build on people’s strengths. What are they doing well?
Prevention• Risk reduction• We cannot always prevent primary or secondary disease or complications.
• People do have the power to reduce their risks.