I am just back from a health conference where I heard too many incorrect terms to wait any longer to make this effort to correct the rest of the world.
Are you a noncompliant diabetic?
Several of these terms are “politically incorrect.” One that I have been careful to avoid for years is to label someone who has diabetes as a diabetic. Now, diabetic medications and diabetic foods are fine. But many people who have diabetes actively resist being labeled as a diabetic, as if we were an illness. A correspondent writes, “What I give as an example to doctors and other technical people is: If a person has hemorrhoids, does that make that person one?” Here, I absolutely agree with the American Diabetes Association, which vigorously resists this label, insisting that we are “people with diabetes.” By using the term people with diabetes we follow the general example of “people-first language.”
Another term that may or may not be politically incorrect but is certainly objectionable to many people with diabetes is noncompliant. For most of us, to be labeled noncompliant is a worse slander than being called a diabetic. This is particularly true when health care people criticize us for not doing things that they haven’t clearly explained or where we think they are wrong.
An endocrinologist friend wisely says, “The ‘noncompliant’ label always grated on me — it’s assuming a model of health care delivery that assumes the doc to be the captain of the ship and the patients to be chained to the oars…”
Control is another important issue. People frequently perceive good control as a value judgement. We should replace it with non-emotional terms like “tight control” or “intensive control” or “stringent control” or “aggressive control.”
Likewise, poor control is a terribly perjorative term implying a “blame the victim” mentality. I haven’t seen the obvious opposite of “tight control” — “loose control” — in the literature; the American Diabetes Association mentions “less stringent,” but I wonder if “uncontrolled” is the easiest answer.
Many people with diabetes also resent the “lifestyle disease” label. It also blames the victims, suggesting that it is their own fault for living an indulgent lifestyle.
Calling diabetes a "progressive disease" is not only incorrect but self-defeating. It is only progressive when we don't take care of ourselves. Please see Is Diabetes Progressive?
Outmoded terms for forms of diabetes are still in use. What used to be called juvenile diabetes or insulin-dependent diabetes mellitus (IDDM) is now correctly referred to as type 1 diabetes. The former terms, adult-onset diabetes or non-insulin dependent diabetes mellitus (NIDDM), are now properly called type 2 diabetes. It is type 1 and type 2, not Type 1 or Type I and Type 2 or Type II. And there is no such thing as borderline diabetes. If that’s what you think you have, it is either pre-diabetes or diabetes. And forget about calling either condition sugar diabetes, and the pills that you might use to treat diabetes are not sugar pills.
Brittle diabetes is another outmoded term. It has been used to describe a pattern of widely fluctuating blood sugars. Most often the cause is a mismatch between lifestyle and treatment program. But too often it is used as an excuse by physicians and patients alike: “This is a case of brittle diabetes and it can't be controlled.”
While the term juvenile diabetes is outmoded, the Juvenile Diabetes Research Foundation International (JDRF) has as much right to keep that name as the National Association for the Advancement of Colored People (NAACP) has to keep its name. However, the JDRF’s former name, the Juvenile Diabetes Foundation, is no longer current. And the organization’s abbreviation is not, for some reason I don’t understand, JDRFI.
To refer to any blood glucose meter as a Glucometer except one of those marketed by Bayer is not politically incorrect — but it is legally incorrect. It is a registered Bayer trademark. See, for example, http://www.bayercarediabetes.com/aboutus/index.asp.
It is also technically incorrect to call your blood glucose meter a monitor. “The device is better called a ‘meter’ because it reports a single readout at a time,” according to an email message I received from someone who certainly knows, Anton H. (Tom) Clemens, the inventor of the first blood glucose meter. “The process of recording a series of individual readings is appropriately called ‘monitoring.’”
There are also even more niggling errors that we really should avoid. One is to refer to blood glucose as “bG.” We see that strange capitalization a lot. It is actually just a most successful marketing tool by the German company, Boehringer Mannheim, which had developed a blood glucose strip called Chemstrip bG. I asked pioneering meter marketer Charlie Suther why he make the b small and capitalized the G. “That was part of my devious marketing,” he replied. “I wanted to worry the people at Ames Company [which is now part of Bayer]. We started the rumor that the little b, big G indicated the first of a whole series of blood tests, bG for blood glucose, bC for cholesterol, bH for hemoglobin — and there was no such development planned.”
Other preferences are non-invasive instead of noninvasive and pre-diabetes instead of prediabetes. And if someone has pre-diabetes, please call it that, instead of the metabolic syndrome, which medical professionals sometimes use as a euphemism so as not to scare the patient. In fact, it’s a lot better to scare someone then, instead of after it’s too late.
When you test your blood, if you haven’t eaten too many carbs, your blood glucose (or BG) might be 100 mg/dl. But don’t write it 100 mg/dL (with a capital representing liters). While “mg/dL” isn’t uncommon, the authoritative Webster’s Guide to Abbreviations lists only “dl” as the acceptable abbreviation for deciliter.
When you say blood sugar instead of blood glucose, it’s not incorrect, although the term blood glucose is more precise. Another good reason to call it blood glucose is that it has an unambigious abbreviation, BG. Abbreviating blood sugar as BS might not be understood the way you intended.
Another ambiguous abbreviation is ADA. While most of us think of the ADA as the American Diabetes Association, it works with another ADA, the American Dietetic Association. Based in Chicago, this other ADA is the world’s largest organization of food and nutrition professionals. The Americans with Disabilities Act is yet another ADA. There are even more ADAs to confuse you when you type in the URL, including the American Dental Association, Applied Digital Access, Audio Design Associates, and probably even more.
Some have suggested adding MODY to this listing of incorrect terms. MODY is shorthand for “Maturity Onset Diabetes of Youth” (or “Maturity Onset Diabetes of the Young”) and certainly seems self-contradictory. People unfamiliar with this acronym often misapply it to any child or adolescent with any form of diabetes not needing insulin, but MODY has a distinct niche, describing a series of rare genetic disorders that are different than the increasingly-common problem of type 2 diabetes occurring at an early age (see Type 2 Diabetes Mellitus in Teens and What is MODY? for more details). So, since there are no other terms for the cluster of MODY disorders, MODY is not incorrect (only illogical).
First published on Mendosa.com on November 11, 2004.
Last modified: January 19, 2010
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