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Appropriate language in clinical settings beneficial in diabetes care

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August 21, 2018

Cathy Lloyd
Cathy E. Lloyd

The language used by health care providers when communicating with people with diabetes influences patient engagement with health services and diabetes self-management, according to a study published in Diabetic Medicine.

“Our review of the literature has found that poor language practices can lead to stigma, lack of engagement with diabetes self-management, low satisfaction with care and poor clinical outcomes,” Cathy E. Lloyd, PhD, professor of health studies in the School of Health, Wellbeing and Social Care at The Open University, United Kingdom, told Endocrine Today.

Researchers performed a search of literature published after 2000 using The Open University library search engine to examine the effect language used by health care professionals has on people with diabetes. They reviewed 68 papers that assessed communication elements of doctor-patient relationships, including stigma, empowerment, cultural competence, patient satisfaction and clinical empathy, and were primarily interested in papers that discussed the outcomes of disease management.

Researchers found that the use of “negative terms,” such as “uncontrolled,” “noncompliant” or “nonadherent,” can cause a disconnect between people with diabetes and health care practitioners that, in turn, leads to negative health outcomes.

They also found that people have different preferences for how they communicate that they have diabetes. For example, some would rather be referred to as “a person with diabetes,” whereas others prefer the word “diabetic.”

Finally, researchers found that health care providers who reinforce stigma by engaging in language choices that place blame or who use stereotypes can cause individuals to disengage with health services and develop diabetes-related distress.

Lloyd recommends good communication skills and more appropriate use of language in clinical settings, which can help support psychosocial well-being and optimal diabetes self-management.

“Further research is needed to investigate the optimal ways of integrating good communication skills into clinical settings, which can have a positive impact on the outcomes identified by the person with diabetes as most important, and which ultimately support self-management, have a positive impact on blood glucose levels, [thus] reducing the risk of diabetes complications,” Lloyd said. – by Melissa J. Webb

For more information:

Cathy E. Lloyd, PhD, can be reached at

Disclosures: The research was funded by a grant from NHS England. The authors report no relevant financial disclosures.


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