TABLE 1.

Suggestions for Improving Messages in Diabetes

Instead of	Use	Rationale
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.