Mind Your Language, by Andy Broomhead

This is a post I’ve been trying to write for quite a while but I’ve somehow never quite found the time or the right words to articulate my point. I think I’ve cracked it this time.


Whilst we spend a lot of time dealing with the day to day aspects of diabetes (blood glucose testing, carb counting, injections etc), it seems we’re becoming more and more accustomed to seeing diabetes in the media and having that part of our lives played out for millions to hear about.


In theory I don’t think that’s a bad thing at all. We know how many of us live with diabetes (over 3.3m), how many are at risk of Type 2 diabetes (up to 7m more people over the next 10 years) and we know how relentless it can be to manage (very). What we as a community struggle with is having a platform to make more people aware of how incredibly serious diabetes is. I think an increasing media spotlight on diabetes can really only be a good thing for us.


However, it’s not without its pitfalls. Whilst we know Type 1 (and a good percentage of Type 2 diagnoses) can’t be prevented, I think we’d all agree the vast majority of diabetes cases can either be avoided altogether or have their onset delayed with changes to an individual’s diet and lifestyle. Using some slightly old data, I’d put that figure at around 75% of all diabetes cases which could be avoided. When we think about the complications associated with those cases (and the cost of managing them), I think we’d all agree that doing whatever we can to prevent them is a good thing. I’m sure no-one would wish diabetes on someone else.


But that’s where things start to get tricky. Despite everyone’s best efforts, the media in general either don’t understand the difference between different types of diabetes, or don’t think it’s important enough to distinguish. What invariably happens is that we as a community get side-tracked into saying “you mean Type 2 diabetes”, “I don’t like the word diabetic” or words to that effect which I think ends up diluting the original point that is trying to be made.


I can see both sides of the coin. The ongoing difficulty is that the wider population don’t understand the seriousness of the condition and believe it to be entirely self-inflicted. It’s hard to blame them for the latter, given we know how many cases could be prevented – though that doesn’t mean we can’t educate people about those unpreventable cases at the same time. It’s also difficult to castigate people for not understanding how serious diabetes can be, as again, we all know that with good self-management and proper clinical support, many of the serious complications can be avoided. We don’t like to face up to our own mortality and thinking about degenerating sight or potential amputation is something we’d generally rather avoid thinking or talking about. I also think there are a lot of other serious conditions out there that we don’t understand as fully as we do diabetes and so it seems unfair to expect everyone to be an expert in our field.


As with our own control, we’re walking a fine line in terms of how we want diabetes to be discussed through the media and amongst ourselves. I think it’s right that people who are at risk understand their position and what it means if they continue without making adjustments to the risk factors within their control. I also think it’s right that anyone living with a chronic long term condition does so free of stigma. But balancing all those things in an article meant to be read by people who don’t necessarily have the background that we all have certainly isn’t a job I’d like to have.


It’s probably unfair to say that those reporting on diabetes wilfully get things wrong, or misrepresent the facts but that’s not to say that we should let the consequences pass us by. Stigma hurts us all and we have a right to be treated with respect.


Throughout this post I’ve used ‘diabetes’ to refer to both Type 1 and Type 2 for the most part and I don’t think anyone would really pull me up for that. Whilst the causes, onset and diagnosis are quite different, many of the management and potential complications are very similar. Talking about ‘diabetes’ in those instances isn’t a bad thing. I know there’s been a move away from using the phrase ‘diabetic’ in the last few years to a friendlier ‘person with diabetes’. I can see the rationale there as you could interpret the former in a pejorative sense, or infer that there’s nothing more to someone than their condition, when we’re all wonderfully unique and multi-talented. But I’m personally not offended if someone uses that term, the same way I don’t mind ‘diabetes’ being used as a blanket term.


When people with diabetes talk about media coverage such as the recent increase in levels of diabetes over the past decade, they’re often quick to point out the difference between the two main types, but perhaps we should be more mindful and talk about ‘preventable’ and ‘non-preventable’ diabetes. It’s something that relates specifically to a wider perception of the condition and gives ‘lay-people’ the opportunity to engage with aspects such as diet and lifestyle changes in a simpler way.


Discussing a complex, lifelong condition like diabetes with those less in the know than ourselves is always going to be fraught with difficulty. I think we should applaud anyone who wants to fight our corner to raise awareness of its prevalence and seriousness, without necessarily coming after them with pitchforks for honest mistakes.


What do you think? Should type-awareness be the media’s biggest priority when commenting on diabetes, or is more coverage (which would hopefully breed better understanding) of greater importance? There’s no right answer on something like this and I’d love to hear what you think.

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