Diabetes: Decreasing the Stigma

Registered Dietitian Nutritionists are important members of the health care team when it comes to caring for patients with diabetes. We are experts at helping our patients and clients count carbs, use the exchange list, and meal plan. But even with the best intentions, it can be easy for RDNs to forget the reality that many of our patients face. November is National Diabetes Month and a great time to focus on putting ourselves in their shoes for a moment. Dealing with the social stigma of having type 1 or type 2 diabetes is often not something healthcare professionals think about when they are talking to patients. Recent studies show that many people living with diabetes have felt embarrassed, guilty, anxious, or had low self-esteem because of comments from coworkers, classmates, friends, media, and even healthcare professionals. One study found that the impact of this stigma was associated with a higher hemoglobin A1c and less stable blood glucose readings, meaning these comments and feelings may have a negative impact on patients’ health. How can RDNs decrease the stigma of diabetes? We can start with our own language and how we discuss diabetes with our patients, coworkers, and community. Below are some recommendations from the American Diabetes Association and the American Association of Diabetes Educators: • Use first-person language like “a person with diabetes” instead of “a diabetic” to avoid labelling someone as their disease. • Avoid using words like “noncompliant”, “failing”, “unwilling”, or “poorly controlled” because these terms can seem judgmental, and often do not take into account the physical and financial barriers that patients with diabetes face. • Focus on the patient’s strengths and what is working for them rather than what can be improved or what the they are not doing well. It is much more helpful to open a listening ear to patients and build a trusting and genuine relationship. Ask them how they feel about their diagnosis and what barriers you can help them overcome so that you can provide them with the best care. It is also helpful to educate the public about diabetes and dispel myths and negative stigma that can be harmful to those living with diabetes in the community. This year, the American Diabetes Association has launched the #EverydayReality campaign to shed light on what it truly means to live with diabetes. Visit www.diabetes.org/everdayreality for more information. Sources: http://care.diabetesjournals.org/content/40/12/1790 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241772/