Table 1.

Metaphors used in tweets to describe the development and experience of diabetes and hypertension^a.

Metaphor themes		Diabetes, n (%)	Hypertension, n (%)	Example tweets
Development of disease (diabetes: n=211; hypertension: n=101)
	Journey to disease	140 (66.4)	62 (61.4)	You can probably get high blood pressure from one large fry at McDonald’s #roadtodiabetes Tips on how to prevent the path to diabetes Couples who develop diabetes together stay together! I really feel the diabetes coming
	Transmittable	53 (25.1)	63 (62.4)	I’d rather catch diabetes than feels I have to avoid diabetes like the plague Stop! you’ll give me diabetes... Don’t talk to me, you’re giving me diabetes. Salty enough to give high blood pressure
	Disease as object	48 (22.7)	1 (1.0)	I could taste the diabetes Mountain dew tastes like diabetes and depression Diabetes for breakfast tomorrow yay I asked for a brownie and instead I got diabetes That’s a nice cart full of diabetes you’ve got there
	Disease as actor	12 (5.7)	3 (3.0)	Hypertension dangers lurking in obese kids When high blood pressure attack No diabetes allowed Like sugar? So does...diabetes Don’t die on me! No diabetes allowed. LOL
Experience of disease (diabetes: n=271; hypertension: n=214)
	Mechanical	38 (14.0)	167 (78.0)	Actually, beer IS good for lowering high blood pressure Shuttling blood sugar into the cells My blood sugar drops drastically today...I feel like my energy has been drained. Still feeling weak until now. I be low then I be high it’s like a battle knife to a gun fight no need to worry it’s the story of my life blood sugar I just had a crazy blood sugar spike
	Control	31 (11.4)	13 (6.1)	Control your high blood pressure Stepped care approach to tackle uncontrolled high blood pressure The best exercise to control high blood pressure seems to be virtually any exercise....Get up and get going! Telehealth may help patients control high blood pressure, but engagement is a barrier The message is to prevent and control diabetes
	War	84 (31.0)	17 (8.0)	Diabetes destroyer In the fight against high blood pressure, potassium is a powerful weapon Simple Tips On How to Battle Diabetes The American Diabetes Association is leading the fight against the deadly consequences of diabetes Slash high blood pressure
	Disease as actor	38 (14.0)	20 (9.3)	Hypertension is a silent killer Oh diabetes, you’re the reason I don’t sleep Diabetes messing with my eyes Diabetes doesn’t define me, it explains me My blood sugar plays funny little tricks on me

^aPercentages equal more than 100%, as some tweets fit into more than one theme.