A focus on language, stigma and communication at the #ADA2019

Highlights of the ACBRD’s contributions to the American Diabetes Association conference 2019

With over 200 sessions in 5 days, attended by more than 18,000 delegates from over 100 countries, the 79th Scientific Sessions of the American Diabetes Association was an event on a massive scale. It is, arguably, the world’s largest and most influential diabetes conference. Consequently, we are always pleased to showcase the ACBRD’s work at this conference.

On the Sunday afternoon, Professor Jane Speight was honoured to be the final speaker in a symposium: Language Matters—Improving Communication in Diabetes Care. Dr Jane Dickinson (Columbia University) set the scene by demonstrating that health professionals’ label people with diabetes (as ‘uncontrolled’, ‘non-compliant’ etc) and sometimes have quite negative and stereotyped views of people with diabetes. She argued that this labelling (particularly in referral letters and clinical records) sets up biases that affect the way the next health professional interacts wth that person. Joe Solowiejczyk (A Mile in My Shoes) was up next, speaking from the perspective of a person with diabetes. He proposed the “be nice” theory of communication, and reminded the audience that healthcare (in the US at least) is a ‘fee for service’ industry – they are in the business of ‘selling health’! He argued that people with diabetes want their experiences validated and they should leave the clinical encounter with courage, determination and energy for their own diabetes self-care.

Dr Kevin Joiner (University of Michigan) followed up with a presentation about the role of the clinician in dismantling stigma. He demonstrated that one of the reasons people with diabetes don’t attend structured education programs is a fear of stigma. He shared new US data showing that at least one quarter of people with type 2 diabetes of African American and Latino heritage report that a) others judge them for their food choices because of their condition, b) others have told them they brought the condition on themselves, and c) blame themselves for having type 2 diabetes. He also showed that diabetes stigma is related to diabetes distress.

Finally, I took to the podium to discuss: Strategies to Improve Communication between Patient and Provider. Taking an evidence-based approach, I demonstrated that clinicians are often reluctant to take the time to wait for the person with diabetes to share their concerns or agenda, and fill the gap with their own agenda – but trusting the process, taking the time to listen and communicate well will pay dividends in improving communication and healthcare. Showing empathy and respect increases honesty, medication taking and other aspects of self-care. I shared resources that can help clinicians embrace a more open style of communication, and brought the symposium to a close by playing the powerful Mytonomy video about language. Following these presentations was a lively debate during which Professor Richard Holt (Editor: Diabetic Medicine) challenged professional societies and journals to do more to support inclusive, person-first language in diabetes.

During the ADA conference, I also presented a poster about the “YourSAY: Quality of Life” study findings in the psychosocial “poster discussion” session.

I and other members of the ACBRD team were also co-authors on another poster presented by Associate Professor John Furler: primary outcomes of the GP-OSMOTIC randomised controlled trial of 3-monthly retrospective continuous glucose monitoring (r-CGM) in adults with type 2 diabetes in primary care.

For more about language and stigma, check out these blogs

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