An American spotlight on language and stigma

One of our highlights from the 77th Scientific Sessions of the ADA. 

by Prof Jane Speight


Given the ACBRD’s long-standing interest in language matters and diabetes-related stigma, we were delighted to see two prominent presentations on these topics for the first time at the recent American Diabetes Association conference.

On Friday 9 June, Dr Susan Guzman (Behavioral Diabetes Institute, San Diego) and A/Prof Lindsay Jaacks (Harvard University, Boston) spoke about ‘the stigma of diabetes – an underappreciated reality’. They highlighted that people with diabetes often face stigma not only from the public and the media (who perhaps do not understand diabetes) but also from health professionals, family and friends. Importantly, Dr Guzman indicated that acknowledging and reducing stigma is vital if diabetes care and research are to attract appropriate investment – citing US budget director, Mick Mulvaney, whose misunderstanding and stigmatisation of diabetes made headlines earlier this year when he remarked: “That doesn’t mean we should take care of the person who sits at home, eats poorly and gets diabetes”.

On Sunday 11 June, Dr Susan Guzman was joined by Dr Jane Dickinson (Columbia University) and Ms Melinda Maryniuk (Joslin Diabetes Center) to present a ‘Joint Consensus Statement on the Use of Language in Diabetes – Why language matters’, endorsed by the ADA and the American Association of Diabetes Educators (AADE). Echoing the Diabetes Australia Position Statement, they noted that word such as ‘non-compliant’ and ‘uncontrolled’ act as barriers to effective care and outcomes. They also highlighted that the words health professionals use can have a powerful effect not only to the person with diabetes but also on the perceptions of that person by other health professionals. Full publication of the consensus statement is expected later this year but Susan and Jane were able to share five guiding principles:

  • Use language that is neutral, non-judgmental and based on facts o Use language free from stigma
  • Use language that is strength-based and respectful
  • Use language that fosters collaboration between clinician and patient
  • Use language that is person-centred

At the ACBRD, we are excited to see these positive care principles being endorsed by such influential professional organisations as ADA and AADE, and look forward to reading the consensus statement in full later this year.