Over the years, I’ve seen many online debates (and participated in a few in-person) about the language of diabetes: the power of it, the meaning behind pairing certain words and phrases together, the connotations that can be unintentional or intentional…or even both at the same time.

As someone who writes as part of my full-time job (and, obviously, as a side hobby on this blog), I try to be very deliberate about my word choice. I may not always be 100% correct in my spelling or grammar – I am human, after all – but I’d like to think that I’m thoughtful in both my writing and my speaking. Specifically, when it comes to talking about diabetes, I’m careful to phrase things in a way that doesn’t discriminate or dehumanize people who live with diabetes, and generally avoid pessimistic undertones. I wrote about this before in a blog post from August 2018 – here’s an excerpt from that post that features some clear examples:

Read the following five sentences. Can you tell what’s wrong with them?

1. She’s a diabetic.
2. He’s testing his blood sugar right now.
3. Her diabetes is out of control!
4. Isn’t that a really bad blood sugar?
5. He suffers from diabetes.

Have you figured it out?

The language in those five sentences is extremely negative. “Bad,” “out of control,” and “suffers” are obviously gloomy and cynical words to use when referring to diabetes – you don’t need to be a wordsmith make that connection immediately. But what’s wrong with “diabetic” or “testing”? It’s the connotations around those words. Calling someone with diabetes a “diabetic” is labeling them with the disease and removing the actual person from the equation. Saying that a person with diabetes is “testing” their blood sugar makes it sound so…clinical. It also implies that the person could pass or fail the so-called test, adding pressure and guilt to the situation.

The Language of Diabetes, Hugging the Cactus, August 2018

So those are just a few sample sentences in which the language of diabetes is definitively negative, in turn, making it more difficult to have conversations about it that are productive. But what about the case of this blog post’s title?

Diabetes is tough.

Or is it…diabetes can be tough?

I think both are true.

I’ve read through a few different social media threads recently in which the phrase “diabetes can be tough” is ripped to shreds. The argument is that people living with it know for a fact that it IS tough, period, bottom line, end of story. There isn’t a gray area where that “can be” belongs, so it simply shouldn’t be the way that folks characterize life with diabetes.

I’m not saying that I disagree with people who are pro-diabetes-is-tough: I absolutely have my days where it’s virtually impossible to live with and I think that nothing in my life is more difficult than my diabetes. Fortunately for me, though, those days are outnumbered by the days in which diabetes and I coexist – not always peacefully, but at least side-by-side with little fanfare. Those are the days that I can say with confidence that I’m fully aware that diabetes can be seriously sucky, but it’s not like that’s always the case for me.

So to me, both phrases – diabetes CAN BE tough and diabetes IS tough – can be true at the same time because it just depends on how easy or challenging it is for me on a given day to manage it. That’s just my truth. Plus, as someone who tends to avoid negative words when it comes to describing my life with diabetes, I like the power that I can find from the “diabetes can be tough” phrasing. In my mind, it perfectly captures and acknowledges that diabetes isn’t easy, but that it isn’t the worst thing in the world, nor does it stop me from living a full life. That’s just my take on the debate. I know folks will both agree and disagree with me, and that’s totally acceptable.

If there’s one thing we can all agree on, at least, it’s that the language of diabetes is a complex matter filled with many nuances.