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BMJ op-ed calls for language change regarding diabetes-related complications

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The way diabetes complications are spoken about should be changed to take away the aspect of blame, according to a new op-ed in The BMJ. Renza Scibilia, a diabetes patient advocate from Melbourne, Australia and Chris Aldred, known as the Grumpy Pumper and from the UK, have written about how feeling "blamed and shamed" for having diabetes complications leaves people feeling unable to talk about them. They posit that certain information regarding diabetes complications attaches blame to people who have failed to manage their diabetes "correctly", and this language needs to change. "Complications are a reality for many people living with diabetes; and the possibility of complications is present all the time," they said. "Changing the language used from 'complications' to 'care' can perhaps reduce the fear and turn the focus to risk minimisation. If choice of words focused on care, people with chronic conditions such as diabetes would be more engaged with their own care and feel more supported. They would then feel encouraged to work with their healthcare professionals to minimise the risk of complications, and to treat early and effectively those that do occur." Last year, using social media and the hashtag #TalkAboutComplications, Chris told the story of his foot ulcer diagnosis, and received a huge response from others sharing their stories. He noted how a recurring theme was feeling "blamed and shamed". "A subtle change in the way words are used could make a difference," said the authors. "Often the focus and language around complications are on prevention rather than on risk reduction. The understanding is that no matter how well a condition is managed, there is always some risk that a complication could develop." People with diabetes can reduce their risk of diabetes-related complications by keeping good control of blood glucose levels, eating a healthy diet and getting regular exercise. Last year, Judith Hendley, Head of Patient Safety Policy at NHS Improvement, wrote about how the way healthcare professionals talk to people with diabetes need to change. She wrote: "It troubles me to be referred to as a 'diabetic' or for people with diabetes in general to be called 'diabetics.'"

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The psychology of this is extremely complicated. Some clinicians are unboubtedly cold and blunt, some clients are overly sensitive. I think in the long run this article says more about the authors than clinical practice etiquette.

I feel these authors are externalising their own problems. Making everyone else responsible for their feelings. I'm sure being labled into a minoroity sucks, whether it's asthmatic, heamophiliac, arthritic, islamic, catholic, african-american etc. It doesnt really matter because how you respond emotionally to that word or label is your responsibility. If that means a lot of soul searching and therapy to sort out why you react the way you do, then so be it. To expect the world to change is unrealistic..

Chances are that once they come to terms with why they react their self care will also improve.
 
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