Speaking to Patients About Diabetes Risk: Is Terminology Important?

Framing a Message About Risk: Use and Perceptions of the Term "Prediabetes"

PurposeThe purpose of this study was to test a survey that investigates individuals' use and perceptions of the term "prediabetes."MethodsA cross-sectional research design and survey method was used, and a 17-item survey was developed by the research team. Individuals in the health field with an interest in diabetes prevention were recruited and completed an online survey.ResultsOf the 97 individuals who completed the survey, 68 reported use of the term. Use of the term very often, fairly often, and sometimes was related to varying beliefs about seriousness, use in clinical practice, influence of communication style, adherence to risk-reducing recommendations, and global definition and diagnosis.ConclusionsIndividuals acknowledged the general impact of their communication and the impact of the term "prediabetes"; however, the variation in perceived impact indicates the need for standardized guidelines for use of the term. Moving forward, it is necessary for individuals who communicate risk with the word "prediabetes" to consider the purpose of using the term and a process for feedback from at-risk individuals about impact or understanding of the term.

Do Words Matter? Health Care Providers' Use of the Term Prediabetes

Communication of risk is not solely the transfer of information; it is an interaction and exchange of ideas between concerned individuals. Health care provider communication about type 2 diabetes risk status may influence individual participation in behaviours that prevent or delay the disease, which is concerning from a public health perspective. The term prediabetes is used to convey risk status and little is known about how health care providers view or use the term. In this article, we describe health care provider use and perceptions of the term prediabetes drawing on data from a survey conducted between August and November 2011 of 15 health care providers practicing in Southeast Wyoming and Northern Colorado USA. We used a grounded theory research design to guide data collection and analysis and in the interviews invited providers to describe their use and perception of the term prediabetes. We found that providers use of the term 'prediabetes' depended on their view of the term's meaning (such as, whether patients were likely to understand or be confused by it) and impact (in terms of motivating patients to mitigate risk). We found there were differences in providers' perceptions of the negative and positive associations of the term and this influenced whether or not they used it. These findings are not surprising given the lack of consensus over definitions and diagnosis criteria for prediabetes. Given this this lack of agreement, there are difficulties about the use of the term prediabetes and its use should take place within effective risk communication. Health care providers must consider essential aspects of risk communication in order to enable individuals at risk of type 2 diabetes to mitigate the risk and by doing so reduce incidence and prevalence rates of the disease.