The language used to talk about diabetes impacts the mental, physical, and emotional health of people with diabetes (PWD) and others’ perception of PWD. While general language recommendations for healthcare professionals (HCPs) exist, less is known about the language surrounding diabetes-related complications. This qualitative study aimed to examine how diabetes-related complications are discussed in clinics, the language used, and the emotional impact of these conversations on PWD. In October 2023, 42 PWD were recruited through the dQ&A US Patient Panel to participate in a 5-day asynchronous online discussion board via QualBoard®. Participants submitted written and video responses to a structured discussion guide and data were transcribed and analyzed using thematic analysis. The resulting participants were 57% women, 81% non-white, and included those with type 1 (21%), type 2 on insulin therapy (38%), and type 2 diabetes not on insulin therapy (41%). Discussions of diabetes-related complications varied by race and ethnicity, diabetes type, and duration of diabetes. Thematic analysis revealed three types of diabetes-related complications that struck the most fear among PWD: eye and kidney complications, and amputation. When addressing these, some HCPs used fear-based approaches, emphasizing outcomes such as blindness, dialysis, and amputation. Language depicting 'loss,' such as 'loss of limbs' or 'loss of eyesight,' used by some HCPs contributed to heightened emotional distress among PWD, and invoked a fear of lost independence or normalcy. Furthermore, framing these complications as 'end stage' prompted reflections on mortality, while the phrase 'kidney failure' led to feelings of personal failure in diabetes management. These findings highlight the use of loss-framing communication and stigmatizing, fear-based language in these conversations, as well as the negative impact this can have on the emotional state of PWD.

Disclosure

M. Garza: Other Relationship; Sanofi. E. Cox: Employee; dQ&A. K. Wilson: Employee; dQ&A. A.J. Morgan: Employee; dQ&A.

Funding

This research was funded, in part, by support from Genentech and Abbott.

© 2024 by the American Diabetes Association
2024
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