Language Guide

People with diabetes, their families, and people at risk of diabetes, deserve communications that are clear and accurate, respectful, inclusive, and free from judgment and bias.


Simple principles for appropriate and effective communication

The words we use to talk about diabetes often reflect a lack of awareness or consideration,
or may express conscious or unconscious bias. 

All of us can:

  • Choose to use language that is neutral, nonjudgmental, and based on facts, actions, or physiology/biology

Healthcare professionals can:

  • Serve people with diabetes more effectively through a person-centered approach that is respectful, inclusive, and imparts hope
  • Use language that is collaborative and supportive and reflects that people with diabetes are individuals with preferences, priorities, and lives beyond diabetes

Media and communications professionals can:

  • Ensure that people with diabetes are represented fairly, accurately, and in the context of a full life
  • Seek out people who live with diabetes to help inform the stories and messages they create

Adapted from the Diabetes Australia Language Matters Position Statement 2021 Summary, ADCES 2021 language guides, and Dickinson et al., 2017. 

Does it matter? Yes.

The language used about diabetes can cause harm

As Diabetes Australia summarizes in their 2021 position statement: Our Language Matters, ample evidence shows that diabetes language…

  • in the media is stigmatizing
  • at diagnosis has a lasting impact (Polonsky et al., 2017)
  • is often unrealistic, inaccurate, frustrating
  • affects emotional well-being and leads to feeling upset, guilty, anxious, frustrated, judged (Dickson, 2018)
  • contributes to social stigma and discrimination
  • affects motivation for self-care
  • affects willingness to take insulin (adolescents with T1D, adults with T2D)
  • affects glucose levels of people with diabetes
  • alienates or isolates people affected by diabetes; loneliness is more harmful to health than smoking
When Referring to People
Instead of
person with diabetes
person living with diabetes
normal person
person without diabetes
victim, suffer, stricken, afflicted

lives with diabetes
Linda has diabetes. She has lived with diabetes for ten years.
Rather than:
Linda is a diabetic.
She has been a diabetic for ten years.
At age 16, Linda was stricken with diabetes.
Linda suffers from diabetes.

Person-first language avoids labeling people with their disease and recognizes that there is more to a person than their diabetes. Some people with diabetes refer to themselves as diabetic; this is their choice and that choice does not affect the recommended practice.

Some people with diabetes (and its complications) find it challenging and distressing, yet few ‘suffer’. Using handicapping language, such as labeling people with diabetes as ‘sufferers,’ ‘afflicted’, or ‘stricken with’ disregards their individual experience and is strongly negative; a neutral description such as ‘lives with diabetes’ is an effective substitute. (Dickinson et al., 2017)


While the recommended term ‘person with diabetes’ has been increasingly adopted in recent years, ‘diabetic’ is still widely used within the diabetes community. 

Why some may choose to use “diabetic”:

Identity-based language is sometimes intentionally used to create a sense of pride among members of a marginalized group. Using an identifier like ‘diabetic’ can be a way to build solidarity among other people with diabetes, and demonstrate diabetes pride. 

Things to consider: 

Research has shown that when identity-first language (‘diabetic’) is used over person-first language (‘person with diabetes’), it can lead to feelings of low self-esteem and isolation which contribute to worse diabetes outcomes. 

The way people talk about, and directly to, people with diabetes, especially in healthcare and media settings, influences the language people in the diabetes community use to refer to themselves. Choosing to use person-first language when talking about people with diabetes can create a large-scale shift, pushing us towards communication that always puts emphasis on the individual.

diagnosed with diabetes
(referring to a person, as opposed to the specific event of diagnosis in a healthcare setting)

living with, or has diabetes

(outside a healthcare setting)
person with diabetes
person living with diabetes
Insulin is an important treatment for people with diabetes.
Rather than:
Insulin is an important treatment for diabetes patients.

Labeling people as ‘patients’ outside of a healthcare setting reduces people with diabetes to their medical condition and positions them as passive participants in their own care. The term ‘patient’ doesn’t acknowledge their humanity; this can lead to mistreatment by healthcare providers and others around them who don’t view them as their equals deserving of respect.


‘Patient’ has become a loaded term, with debate around whether it should be used outside of clinical settings, or used at all, to describe people with diabetes. 

Why some may choose to use ‘patient’:

The terminology used to describe people depends on the context they are put in and the people they interact with. In various settings, people take on the identities of ‘patients’, ‘clients’, or ‘consumers’, to name a few. ‘Patient’ is the default term to refer to people who are receiving care by a healthcare professional, and can be preferred by people with diabetes and healthcare professionals when receiving or administering care in a healthcare setting. 

Things to consider: 

When people with diabetes are referred to as ‘patients’ in the healthcare setting, this term can endure even when they aren’t seeking care in a doctor’s office which can be dehumanizing. 

The argument for always using ‘people’ stresses that in all contexts, they are people first. Referring to individuals as ‘people’, especially outside of the healthcare setting, acknowledges their personhood which can influence the way these people are viewed and treated.

(in research)
participant(s), people

Study participants include 80 people with diabetes and 80 people living without diabetes.
Rather than:
Our study population includes 80 diabetic patients and 80 normal subjects.

Researchers have traditionally labeled those who take part in studies as ‘subjects’. However, people who take part in research consent to do so and rarely sit passively and have things done to them. They are often active, undertaking a number of tasks and activities. People who take part in research deserve to be treated with respect. In addition, research participants are not always ‘patients’ and should not be referred to as such. (Speight et al., 2021)

finding it difficult
has concerns about...
has other priorities right now
in denial,
participant(s), people
Dan understands that diabetes can harm him; he does not see diabetes as a priority with everything else that’s going on in his life right now.
Rather than:
Dan is in denial.
Dan is unwilling or unmotivated to deal with his blood glucose.

‘In denial’ is inaccurate. Most people described this way know they have diabetes and are not denying that they have it. This is instead a reflection that the person does not see diabetes as an important and/or immediate concern. 

Few people are unmotivated to live a long and healthy life. The challenge in diabetes management is there are many perceived obstacles that can outweigh the understood benefits. As a result,many people come to the conclusion that changes are not worth the effort or are unachievable.


is obese

has excess weight, has obesity

Though Susan has obesity, she is still very active and goes to the gym several times a week.
There are many people with obesity or excess weight in the US.
Rather than:
Susan is obese.
Susan is overweight.
Obese patients are more difficult.
There are many obese and overweight people in the US.

The terms ‘obese’ and ‘overweight’ are often used to describe people in a way that suggests the person’s body size is a characteristic or trait of theirs, and not a state or medical condition. It also dehumanizes people when others use condition-first language such as, “She is an obese person.” (Speight et al., 2021)

Weight bias is extremely prevalent and leads to worse health outcomes and outright discrimination for people with obesity (Puhl et al., 2009). Stigmatizing language contributes to this bias and disempowers people.


Obesity is a medical condition, but there is no universal agreement among scholars about which term is the ‘recommended’ term to use when talking about and to people with obesity or excess weight. More research is needed to understand which language is preferred by diverse populations and which language empowers people and leads to better health outcomes. Generally, person-first language is the recommended choice when talking about medical conditions..

Why some may choose to use different language:

Especially for healthcare professionals and researchers, Puhl et. al. highlighted that different populations find different terms more negative than others. So the ‘right’ term for a white woman who is trying to lower her body weight might not be the ‘right’ term for a Black man who is participating in a research study (Puhl et al., 2020).

Things to consider: 

For healthcare professionals and researchers, because each person may respond differently to the language being used to discuss body weight, it is often best to begin any conversation with neutral language, such as using exact numbers to describe a person’s weight instead of a term with value judgment like obese or overweight. From there you can ask the person what language they are comfortable using when discussing their weight. This can help bring people into the conversation about their health and empower them to choose the language they want to use, without making assumptions about what language is best for them. (Puhl et al., 2020)

For communications professionals and journalists, it is usually best to use person-first or neutral, fact-based language as often as possible, unless asked to do otherwise by the individual(s) you are talking about. 

When Referring to Diabetes and Complications
Instead of
diabetic or diabetes complications

diabetes-related (-associated, -specific) complications;
complications related to diabetes
Brandon has diabetes-related heart disease. He also has other complications related to his diabetes.
Rather than:
Brandon has diabetic heart disease.
He has a bunch of diabetes complications.
His diabetic complications led to a foot amputation.

Using the terms, ‘diabetic,’ or, ‘diabetes complications,’ can have unintended consequences. It incorrectly ties a complication to all people with diabetes. Saying, ‘diabetic heart disease,’ can make it seem like all people with diabetes will experience this complication, which is untrue. In addition, it dehumanizes the issue by focusing on treating just the problem or specific body part, and not the whole person. In addition, describing the complication as being ‘diabetes-related’ is more scientifically accurate. (Speight et al., 2021)

mild diabetes,
mild hypoglycemia
don’t label:
just say diabetes;
self-treated hypoglycemia
Sean has diabetes and was able to self-treat his most recent hypoglycemia episode.
Rather than:
Sean has a mild case of diabetes.
Sean recently had a mild case of hypoglycemia.

‘Mild diabetes’ does not exist. Diabetes is a serious issue and labeling it as such is inaccurate and inconsiderate to people with diabetes. (Speight et al., 2021)

People with diabetes can experience low glucose levels, also called hypoglycemia. Sometimes, hypoglycemia can be self-treated. However, even in these instances, the hypoglycemia is not ‘mild.” Describing it as such ignores the effects of hypoglycemia that can have a very real impact on people’s lives and it ignores the effort that people with diabetes put in to avoid severe hypoglycemia. (Speight et al., 2021)

context dependent: “disease” in a medical context is an accurate term; in other contexts, some people prefer “condition”
Robyn has diabetes, but she doesn’t let her condition slow her down.
Rather than:
Robyn has diabetes, but she doesn’t let her disease slow her down.

The term disease has a negative connotation that often brings to mind something contagious or gross and people with diseases are often avoided by others. By describing diabetes as a condition, you are more accurately portraying the chronic nature of diabetes and the ways it must be managed.


While the recommended term ‘condition’ is preferred by many, there are some cases in which disease is more appropriate.

Why some may choose to use “disease”: 

In medical terms, diabetes is a disease. There is a clear functional impairment in the body, which is the way the body produces or responds to the hormone insulin, and a set of symptoms that result from this. In a medical context, it may be appropriate and/or useful to use the term “disease” when talking about diabetes.

Things to consider: 

The word “disease” can carry negative connotations, which can impact an individual’s self-perception and management of their diabetes. It can also impact the way other people view diabetes, which can affect the way they treat people with diabetes. “Condition” could be a more neutral alternative that allows people with diabetes and others around them to view diabetes as manageable, non-threatening, and non-communicable. 

When referring to managing diabetes:
Instead of
adherence / compliance,
e.g. adhere, (non-) adherent;
comply, (non-) compliant
words that describe collaboration or doing specific behaviors, e.g. taking medication, checking glucose levels

Jan checks her glucose levels regularly and takes her medications in the morning with breakfast.
Rather than:
My patient, Jan, complies with my recommendation.
She adheres to her recommended medication plan.
Jan fails to adhere to her treatment plan and is often non-compliant and difficult.

Using terms that imply collaboration between the person with diabetes and their healthcare professional is empowering and highlights that people with diabetes are not passive in the management of their condition. Words like ‘adherence’ and ‘compliance’ suggest that healthcare professionals are always correct and that people with diabetes are disobeying them if they are not able to follow orders exactly. In reality, diabetes management is more complicated than simply ‘following orders’ and terms like ‘adherent’ and ‘compliant’ ignore the many challenges people with diabetes face every day.

It is accurate, descriptive, and neutral to describe the actual choices or behaviors of a person with diabetes and the effects it has on health outcomes.

control (referring to diabetes, HbA1c or glucose levels);

manage glucose levels
within/outside target range
high/low glucose levels
target glucose levels

[“ ...experienced ____ and the result was ____”]

examples to avoid: poor control, good control, normal control, well controlled, poorly controlled, uncontrolled, diabetes control, metabolic control, glycemic control, glucose control
Tim manages his glucose levels with metformin and exercise.
Tim sometimes has high glucose levels outside of his target range.
Tim ate a sandwich that caused his glucose levels to rise higher than he wanted.
Rather than:
Tim controls his diabetes with diet and exercise.
Tim sometimes loses control of his glucose levels when he eats a dessert.
Tim has poorly controlled diabetes.

A person’s diabetes is influenced by many factors outside of their ‘control’ including socioeconomic factors, hormones, access to medications and technology, their environment, stress, etc. (Speight et al., 2021) 

‘Management’ is preferred over ‘control’ because it acknowledges the effort people put in to maintain their health and it acknowledges the improvements people can make over time. The term ‘control’  can lead to feelings of guilt, shame, and frustration and implies that if people try hard enough they can ‘control their diabetes,’ which is untrue given the many external factors that affect diabetes and the landscape of medications and technology currently available to people. (Speight et al., 2021)

intensify / escalate treatment

tailor/personalize/change to more effective or appropriate treatment(s)

Kyle, let’s try personalizing your medication regimen to see if we can get different results.
After Kyle ended up in the ER, he increased his dosage of metformin by 100mg.
Rather than:
Kyle, we are going to have to intensify your insulin treatment.
We will need to escalate your treatment to get better results.
After Kyle ended up in the ER, his treatment was intensified.

When people with diabetes need to change their treatment, it is crucial to discuss this change in a way that feels approachable and achievable. Using words like ‘intensify’ and ‘escalate’ can incite fear  or make the adjustment seem burdensome. This can lead to people with diabetes delaying the necessary changes to avoid feeling scared or dealing with a difficult change, which can have a negative impact on their health. (Speight et al., 2021)   

correct(ing) glucose levels

adjust(ing) insulin,
optimizing glucose levels
fail, failing to, failed, failure

did not, has not, does not...

example to avoid ‘they failed on metformin’
good/bad/poor (referring to glucose levels)

use the numbers, refer to choices

‘being a bad diabetic’
making choices/decisions
Sara adjusts her insulin dose when she is exercising to keep her glucose levels in range.
Monique ate ice cream and now her glucose level is 185 mg/dL.
Sam is not as active as he could be.
Rather than:
Sara had to correct her glucose levels during a run.
Monique is failing to control her diabetes and has really bad glucose levels because she ate ice cream.
Sam is a bad diabetic and refuses to exercise. He even cheats on his diet.

When discussing the choices people make and the health outcomes that result, it is more accurate and considerate to be descriptive and neutral without assigning a value judgement to the choice or result, such as ‘failed,’ ‘good,’ ‘bad,’ or ‘poor.’ In addition words like ‘correcting a glucose level’ implies the need to fix something that is wrong or incorrect. All of these terms can lead to people with diabetes feeling guilty, blamed, or ashamed, of the choices they make. (Speight et al., 2021)

test/testing (when referring to blood glucose monitoring/fingerstick)
monitor/monitoring (e.g. glucose)
read/reading (e.g., on a CGM)

[explicit: not talking about lab tests]
Evita checks her glucose levels with her continuous glucose monitor.
Rather than:
Evita tested her blood sugars.

‘Tests’ are associated with results, scores, or grades. You can ‘pass’ a test, or ‘fail’. ‘Testing’ your blood glucose can imply that blood glucose level is a score, which can feel like a ‘failure’ if people see a value that is higher or lower than target. Using words like ‘check’ or ‘monitor’ are more enabling words, which provide people with diabetes with information they can act on without the negative association. (Speight et al., 2021)

treating diabetes

helping people manage diabetes,
managing diabetes
We are helping about 50 people manage their diabetes in our office.
Rather than:
We are treating about 50 people for diabetes in our office.

‘Treating diabetes’ or ‘treating patients’  implies that providers are doing something to the person with diabetes, who is passively accepting treatment rather than being an active participant in their care. Providers are giving people with diabetes the tools to effectively manage their condition, empowering them to make their own informed decisions about their health. (Speight et al., 2021)

Language tools resources

For writers and media professionals

Taken together, these 2021 ADCES resources includes four recommendations for communicating about diabetes and specific guidance on how to avoid language that conveys blame and reinforces stigma.

Scientifically accurate, up-to-date information on a variety of health topics and conditions as well and provides expert consulting resources for media professionals.