“Diabetic” and “Noncompliant Diabetic”: Terms That Need to Disappear

Abstract

“D r. Johnson, I have roomed your patients. Mr. Jones is a new diabetic in room 1; Mr. Smith, the noncompliant diabetic, is in room 2; and Mrs. Anderson, the gestational diabetic is in room 3. This morning's schedule is filled with diabetics.” How many of you are gritting your teeth after reading this scenario? Hopefully, all of you; it was painful even writing it. When referring to people with diabetes, we should stop using the labels “diabetic” and “noncompliant diabetic.” These terms expose our ignorance to the management of diabetes and allow us an excuse when patients are not achieving their heath outcome goals. Currently, only 57% of people with diabetes achieve an A1C of < 7%.1 Albert Einstein once said, “We can't solve problems by using the same kind of thinking we used when we created them.”2 I agree with Einstein and argue that if we eliminate the use of the terms “diabetic” and “noncompliant diabetic” we will improve diabetes care. Because of a feeling of helplessness, health care providers may label patients as noncompliant as a way of blaming patients when they do not follow our advice.3 Labeling patients as noncompliant as a method to motivate them to reach their health outcome goals is as successful as telling a spouse that he or she is a horrible cook and expecting him or her to happily make us future meals that exceed our expectations. Neither method of motivation will work. I believe that, by focusing on the individual instead of the disease, health care professionals will allow patients to reach their treatment goals and will, ourselves, find greater joy in managing …