From language matters to stigma-free communication in diabetes: Evolution, challenges, and next steps

Abstract

Language profoundly shapes how diabetes is perceived, experienced and managed, with the potential to perpetuate stigma or promote dignity and respect. This expert review, conducted by an international, multidisciplinary team, traces the evolution of the global diabetes #LanguageMatters movement and synthesises evidence on the effects of language on diabetes management, health and wellbeing, alongside community-preferred terminology. We identified 32 language position statements/guidance documents published in more than 19 countries. Most are applicable to all diabetes types, diverse audiences and address verbal communication; many also consider non-verbal, paraverbal and, to a lesser extent, visual communication. Beyond recommendations of terms to use or avoid, these statements articulate overarching principles grounded in person-centred, strengths-based, empathic and non-judgemental communication. Evidence of uptake is emerging, including incorporation into clinical standards and research presentation guidance, alongside gradual shifts in language use within some research and media contexts. However, implementation remains uneven, and stigmatising language persists across healthcare, research, policy and public discourse. Despite growing momentum, empirical evidence on community preferences and robust evaluation of adoption and impact remain limited. Language practices are also evolving alongside new technologies, screening approaches and therapeutics, creating additional challenges and opportunities. We identify key gaps in evidence, guidance and implementation mechanisms, and highlight persistent and emerging forms of hidden stigma within systems and structures. We propose a constructive agenda centred on community partnership and system-level implementation. Treating language as foundational to person-centred, equitable and compassionate diabetes care is essential to ending diabetes stigma and discrimination across all settings.

Keywords: patient experience; psychology; psychosocial.