BMJ: Asking better questions in the diabetic clinic

Adapted from BMJ 24 Nov 18

Are you well controlled?

Judith Hendley writes:

I am a mum who has type one diabetes. It troubles me to be referred to as a “diabetic”. Although this doesn’t bother everyone, I feel that this reduces me to someone with diabetes and nothing more.

Once diagnosed you are referred to as a patient for evermore. No matter how healthy and active I am, I seem to have crossed an invisible line from the “healthy” to the “unhealthy”.  I don’t want assumptions made about me and I don’t want the first question I am asked to be about my most recent HbA1c result.

The language used by healthcare professionals, the media and others makes a big difference to how I feel about living with a long term condition.

Living with type one diabetes requires mental agility, resilience, stamina, perspective and a healthy sense of humour, so state of mind is everything and language plays a big part in that.

There are questions that particularly get on my nerves.

Instead of saying, “Do you suffer from diabetes?” it would be much better to simply ask, “Do you have diabetes?”

I am sometimes asked if I am “well controlled”. It makes me want to reply, “No. In fact you just can’t take me anywhere.”

I often think that health care professionals don’t realise how difficult keeping a consistent equilibrium with diabetes really is. I would like to be asked questions such as,

” How are things going with your diabetes.”

“Are you having any difficulties with your blood sugar at the moment?”

“Are you finding anything particularly challenging?”

Open, non judgemental questioning is best. “How are you feeling about your diabetes at the moment?” “What is most important to you right now?” “What ideas have you thought about for how you could handle that?”

I realise some people may think I’m being overly precious about language, but health care professionals would be seen as much more “on side” and they could still get all the relevant information they need, if they just minded how they phrase things to patients.