# “Do You Understand What I Am Saying?”: Exploring Language Practices in Describing Life With Diabetes

## TL;DR

This study explores how people with diabetes use language to express and protect their identity when discussing life with the condition.

## Contribution

The study introduces a novel application of Identity Process Theory to analyze language practices in diabetes narratives.

## Key findings

- Participants used metaphors and similes to make their diabetes experiences more relatable.
- Distancing strategies like sarcasm and objectification reflected a sense of ownership over diabetes.
- Clinicians can gain deeper insights into patient identity through attention to language practices rather than direct questioning.

## Abstract

Language is a vehicle to express and defend one’s desired identity by employing socially normative strategies to promote and protect a preferred identity. In this qualitative secondary analysis, we explored the language practices in 30 interviews with 15 adults with diabetes who use insulin pumps. Inductive thematic analysis guided by Identity Process Theory illuminated how participants expressed and defended their preferred identities. Language strategies such as personification, humour, sarcasm, metaphors, similes, co-constructed stories, and joking, indicated trust with the listener and the speaker’s association with diabetes. Metaphor and similes provided a comprehensible analogy to articulate experience. Distancing strategies, such as objectification and sarcasm, reflected a sense of ownership of diabetes. Protecting self-esteem and self-efficacy through whispering and justification was important when describing diabetes practices as deviant or individualized. Clinicians’ attendance to language practices gives insight into identity and identity threats in a way direct questioning cannot.