9 Diabetes Terms We Can Do Without
Let’s get one thing straight: Your diabetes doesn’t define you. Character is forged by your life experiences and your environment—not by how well your pancreas works. Yet we allow certain terms to creep into our vernacular until we’re defining ourselves and others, too. That needs to stop, starting with the words and phrases below.
1. diabetic, n.
There’s a reason the American Diabetes Association, Diabetes Forecast, and most scientific journals avoid using the term “diabetic” as a noun: People with the disease are diverse individuals, not a single entity. Some people identify themselves as “diabetics” and find that the term provides a useful narrative framework in which they manage the realities of living with the condition. But not everyone feels that way.
Many people with diabetes see the term as stigmatizing. They advocate that the language used to describe the condition and the person living with the condition be carefully distinguished. Another reason “diabetic” should be scrapped? Defining a group of individuals with a similar disease by their condition may prevent others, including family members and health care providers, from thinking about their experiences and needs as individuals.
2. bad, adj.
People speak about “bad” glucose readings, a “bad” A1C, or an overall “bad” day. But the data don’t define you. That is, you are not your number.
The idea of a “bad” number can unintentionally discourage self-monitoring by focusing attention on a so-called mistake. It’s a poor motivator for ongoing, upbeat self-care, especially when a person already carries around guilt (such as, “It’s my fault I have diabetes”). Using the word “bad” to refer to blood glucose or A1C numbers also hinders collaboration with health care providers. Revealing blood glucose records to a doctor can be intimidating, especially if you anticipate hearing about how “bad” your numbers are.
That’s why doing away with the idea of “bad” numbers is crucial. Sharing home-monitoring trends and engaging in mutual problem solving enables people with diabetes and providers to evaluate and, if necessary, try other strategies.
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3. brittle, adj.
“Brittle” has been loosely used to describe erratic blood glucose levels that are difficult to control. The term “brittle patient” (or the double whammy, “brittle diabetic”) implies that attempts to manage diabetes are futile. Those labeled “truly brittle,” a term without any definition, may feel that health care providers have given up on them. Fortunately, if people with erratic blood glucose levels work with their providers, their diabetes can usually be managed with enhanced treatment, technology, support, and education.
Because “brittle” carries so much baggage and doesn’t help improve health, the overused label should be put to rest. The next step: encouraging scientists to define solutions for people whose conditions defy the best that medicine has to offer.
4. cheat, v.
We all cheat. And often. It’s human nature. But ruminating on cheating doesn’t help people with diabetes move toward better outcomes. This pejorative term is only good for one thing: promoting self-punishment and feelings of shame. It’s much more effective to focus on all the healthy choices you make each day. Praise is a much better motivator than criticism.
5. complications of diabetes, n. pl.
The phrase “complications of diabetes” assumes that complications are inevitable. Although uncontrolled blood glucose levels do correlate with some complications, there are genetic and unknown factors that play a role, too.
Repeatedly being hammered with the possibility that you’ll develop life-altering complications as a means to motivate health behavior (“Take better care of yourself or you’ll lose a leg”) is harmful. Terror can be paralyzing, making diabetes management difficult. Let’s blame the insidious nature of diabetes for the damage, not the people living with it and caring for it as best they can.
6. denial, n.
Denial is a normal reaction to many things in life, including a diabetes diagnosis, but it can be a barrier to self-care. Some people are mistakenly labeled as “in denial,” and their state of mind is blamed for their poor control. The true barrier may actually be a lack of understanding about diabetes management or other factors, such as lack of enough family support
or money, or depression (treating it can help).
The closer you can get to describing the issues that are bothering you, the better you and your support teams can work together. Remind yourself that you are the expert on your life and that providers advise you based in part on what you share. When you shrug off good advice by saying, “I’m in denial and can’t make any changes,” you sell yourself short. An attitude of denial can prevent you from moving forward and managing your condition. When this is the case, mental health providers are great assets.
7. failure, n.
Given that there are so many things that people have to do to manage diabetes, it is not surprising most report feeling like a failure at times. Sometimes, other people’s feedback only reinforces this idea. It’s hardly empowering to hear that you’re a “diet failure” or an “oral agent failure.” The same goes for telling yourself you failed to meet A1C goals. Negative talk like that does more harm than good.
Because diabetes is a dynamic process, not achieving a goal can be redefined as a moment of opportunity, one providers and people with diabetes can use to assess the elements of treatment that aren’t working and look at other options. So, if oral medications are no longer effective, it may be time to consider taking insulin. People with diabetes experience better health and quality of life when treatment plans are individually chosen based on needs and modified through the years.
8. noncompliant, adj.
Do you do everything your providers tell you to do? All of the time? If not, welcome to the club. (We’re members, too!) We all have reasons for why we don’t do the things we know are good for us. Maybe you’ve experienced hypoglycemia in the middle of the night and have stopped taking your nighttime long-acting insulin. Your doctor might call this noncompliance, but you call it self-preservation. Being labeled “noncompliant” doesn’t help get to the root of these issues. Nor does it prompt people with diabetes to change.
Too often individuals with diabetes bear the sole responsibility for implementing effective diabetes management. Yet diabetes care is complex and challenging. To meet your unique health-related goals, collaboration with your health care team is essential. Look for providers who actively listen and create a safe environment for talking about why you are not doing a particular element of your treatment. Together you can discuss what is getting in the way and brainstorm other approaches.
9. unmotivated, adj.
People with diabetes are too often judged by themselves and others as not being motivated. The reality is that often people are motivated—but not necessarily to do what someone else wants them to do. That is, being motivated to lower blood glucose levels because you want to keep up with your grandchildren is very different from being told you have to manage your diabetes.
When the term “unmotivated” is tossed around, it can frustrate both people with diabetes and their providers and wreck the hope and motivation needed for effective care. Instead, motivation is enhanced by working with providers who collaborate with you to find the best approach for your care. It can also be helpful to identify discrepancies between what you are experiencing in your life (say, exhaustion from high blood glucose levels) and what you want to experience (such as a game of tag with the grandkids). Finding meaningful reasons to invest the time and effort needed to take good care of yourself is a positive start. After that, motivation is built one step and achievement at a time.



Comments
Comments are subject to review and will not be posted immediately. If you have an urgent medical question, please consult a health care professional. If you have a question for the staff of Diabetes Forecast, please send it to replyall@diabetes.org.translation of article
I would love this in a spanish version, I have a large group of hispanic spanish speaking only patients.
We're having the piece
We're having the piece translated and will post here as soon as it is available in Spanish. Thanks for your suggestion. —Kelly Rawlings, Editorial Director
Type II
I'm 43 years old, 6'3" and weigh 182 pounds. I've been using an insulin pump for about five years (and shots before that). I don't like being lumped in with people who develop Diabetes because they couldn't control their eating, gained a hundred pounds and developed Type II Diabetes. Many of their issues go away when their weight is controlled, and never would have come up if they just didn't become obese.
You might find it
You might find it interesting to read the article on this site titled "Why Me? Understanding the Causes of Diabetes." Here's what it says about weight and type 2:
Being too heavy gets the bulk of the blame for triggering type 2 diabetes. According to the National Institutes of Health, about 85 percent of people with type 2 diabetes are overweight or obese. But consider that the remaining 15 percent are not. Consider, too, that roughly two-thirds of overweight people and a third of those who are obese will never develop diabetes. In other words, normal-weight and thin people also develop type 2, while heavy people won’t necessarily. Clearly, there is more to the connection between lifestyle and type 2 diabetes than just body size.
I was 47 when diagnosed with
I was 47 when diagnosed with type2. I was not obese (6'1" 240. Body fat at 15%) You are type 1. So what!? I could blame your genetics on your type1 but i won't. Everyone is different and diabetes is caused by varying factors in each person. Your comment is callous, like saying someone with cancer caused that disease themselves. The reason I developed diabetes is different than the reasons you developed it. The fact is WE BOTH have it. It is people with your attitude that make the newly diagnosed feel shame for having the disease. As the character Sgt. Hulka said in the movie Stripes "Lighten up Francis! ".
anaonymus type II
As someone your weight and age, I iam baffled by your phrase "if they just didn't become obese" and "if they just controlled their weight". I have a medical condition that maked enthusiastic movenemt (areobis, running, laughing, coughing) embarrassing. I do what I can as far as physical excersize, but srtenupus activity is no longer viable. I didn't "just become obese", and I don't eat sweets or starchy foods. I simply am not able to excersize in a way that will"controll"my weight, which has been stable, if high, for years.
Perhaps the article could be expanded to phrases people with diabetes no longer need.
Hmmm
Lol, why don't you petition the government to throw all the fat people in jail or send them to mass graves. I mean, we are pretty much the last exceptable prejudice in society these days! I'm obese and I developed Type II Diabetes. It probably IS my fault but that doesn't make it any less deadly or scary. I admit, I have used my past of abuse, grief, rape etc as an excuse. However, now I'm taking full responsibility for my decisions and health and I'm trying to do something about it. I continue to run into people like you at my work, at the gym and even in my own home. It's unfortunate that so many doctors feel the same way that you do. The lack of education and compassion in the medical field and in society only encourages intolerance and desensitizes others to remarks like that. It's ironic that the one place I would think would be free of prejudice and judgement, is where I find your comment. However, I live in America where freedom of speech is king. I appreciate that You and I can express different opinions and are NOT hung, stoned or shot to death because of it. I would be more than happy that YOU were not lumped in to any category that I'm in. Your anger and intolerance is on you. I have a friend who's daughter suffers from type I diabetes and they nearly lost her a few times. She is so full of love and compassion. You don't speak for everyone with your disease. As I don't speak for mine. :)
I understand your frustration
Hey, I understand your frustration completely. I don't like being told that I’m a diabetic because of something I did or didn't do. It REALLY irritates me when people tell me that I could "cure" my diabetes by eating better or exercising more! Umm... that would be awesome, but it's not the truth; not even for type 2's. Regardless of which "type" of diabetes you have, maintaining a healthy weight and exercising can help with blood sugar control…still there is no CURE for either "type".
It's a shame that type 1's have to put up with this nonsense, but not any more so than it is for type 2's. The real culprit here is the constant barrage of misinformation perpetuated by the media, talk show “doctors”, and commercial weight loss programs, and even the medical/healthcare industry itself. The American public is inundated with the idea that obesity = diabetes. At the very least this is a gross oversimplification; at worst it’s completely inaccurate. While weight plays a role in this complex disease, it’s only one factor and it’s a factor that’s not well understood… it’s no big secret that insulin resistance/excess circulating insulin (the hallmark of type 2 diabetes) can cause weight gain. Hmm…maybe we’ve been going about this from the wrong direction?
So let’s stop playing the blame game and demand more accurate information from the media and the healthcare industry itself. While we’re at it, we might want to start questioning the healthcare industries motives. Why do test strips cost a dollar each? Where is the government in this? Can anyone say price gouging? Let’s fund and support REAL science and those who are seeking a REAL CURE… not simply solutions that keep us on life support. I for one am tired of the "diabetes industry" -- you know the companies and organization that are taking gleeful advantage of the increasing incidence of both type 1 and type 2 diabetes. Their only motivation is profit, so it’s important to keep us reliant on testing supplies, pump supplies, CGM supplies, medical tests, appointments, medications (on and on it goes). My point is, diabetes is hard enough let’s not make it harder on each other.
Blame
I cannot believe what I am reading. Do you actually think we asked for this disease; did you? I think not! Your remarks are insensitive and uncalled for. I think you need help with your obvious feelings of anger and resentment, which cannot be good for you or anyone else. You have no idea why someone developed their diabetes and to group all type 2's into one category is inaccurate and offensive.
Its a disease
Not sure if disease is acceptabe in this forum but thats what it is. Regardless of how we got it or what terms you use etc etc...what are the solutions. In America today we get so hung up on semantics and words and feelings and emotions...we need to get over ourselves and find solutions. Maybe if we did not live by our emotions quite so much we would have fewer over weight and obese people and way fewer people with _ _ _ _ _ _ _ _did not know how else to not say it! Donate your money and time and find a solution to the disease in all its ugliness.
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