Should Doctors Watch Their Language?

If you’re a diabetic with bad blood glucose control because you’re noncompliant with your treatment protocol, chances are your outlook for improvement will be pretty bleak.


But if you’re someone with diabetes who faces barriers to optimal control and aren’t reaching your blood glucose targets as a result, you may feel more motivated to make changes that help improve your diabetes management. That’s the message, in a nutshell, of a new statement released by a committee tasked with recommending what language doctors should use — and avoid using — when discussing diabetes with patients.

The statement was released last week at the American Diabetes Association’s 77th Scientific Sessions in San Diego, as part of a session called “Why Language Matters.” The 10 committee members who wrote it hope that it gets accepted and published by the American Diabetes Association — right now, it’s simply a proposal.

As noted in an article on the statement at MedPage Today, the authors recommend that that doctors not use the words “uncontrolled,” “non-adherent,” or “diabetic,” among others, when referring to patients and their diabetes. They also write that words like “good” and “bad” shouldn’t be used to describe blood glucose levels or control. Doing any of these things, they write, can convey a negative attitude that makes it more difficult for people to get motivated to improve their health.

The statement covers a total of five recommendations:

1. Using language that is nonjudgmental with patients. Rather than saying someone’s diabetes is “not well controlled,” for example, a doctor could say that someone’s HbA1c level (a measure of long-term blood glucose control) is “above the target we discussed.”

2. Using language that is nonjudgmental in discussing referred patients with other health-care professionals, since this can help shape the providers’ attitudes in working with the patients who are referred.

3. Using language that is positive and optimistic. Rather than telling someone they need to be monitoring their blood glucose more after meals, a doctor could praise their overall testing and ask what might help them test more after meals.

4. Using language that encourages collaboration, such as asking about concerns and challenges that might be standing in the way of treatment goals.

5. Using person-centered language, including avoiding the term “diabetics” and speaking directly to the patient’s situation rather than in generalities about what people should do.

What do you think of these recommendations — are they good, and are they realistic? Can doctors go too far in being nonjudgmental, making patients feel like anything they do is all right? Do you think you’d feel more motivated to manage your diabetes after a scolding or positive encouragement? Have you noticed that your doctor tends to use one of these approaches or the other? Leave a comment below!

Want to learn how to make the most of your doctors’ visits? Read “Planning for a Successful Doctor’s Visit,” by registered nurse and certified diabetes educator Janet Howard-Ducsay.

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  • Cindy Lou

    I am diabetic,, that’s that. I would like less chronic and progressive sad face, and more positive help regarding get a newly diagnosed patient right in with the dietitian and teach them how to control and how to test and what those numbers mean. If it went like that from the beginning there would be a lot more patients like me who control with diet and exercise, rather than having to rely on medications so much!

  • linda6521

    I am diabetic and know several other diabetics. It probably doesn’t hurt to scare newly diagnosed patients a little. Someone has to get their attention as to the gravity of the disease. Education comes first: diet, exercise, direction to this magazine to provide reminders and suggestions. Always include family members in education. Once treatment begins, positive reinforcement goes a long way. Praise any changes the patient has made. Encourage the patient to take responsibility for their own treatment plan. “What do you think you can do better?” ” What one thing can you change to improve your BG numbers?” “Were you able to implement the changes we discussed last time?” “What obstacles in your life keep you from making changes?” “Did you fall off the wagon in some area? What can you do to get back on?” Fully discuss the implementation and obstacles of any suggestion. Help with plan for changes.

  • AlaskaFreddy

    …. and all these pictures of wrinkled up old chaps talking with a young doctor who is as out of shape as the President of North Korea, – give me a break. Most of these doctors are either fat, out of shape, suffer from bad nutrition, or bad water, and couldn’t climb a set of stairs even if they owned their own crane. Sorry (smile).