Every so often, a discussion will pop up about how to refer to those of us with glucose metabolism issues. Whether it's "diabetic versus person with diabetes", "borderline versus prediabetes", or even the whole "Type 1 / Type 2 / Type 1.5 / Gestational / Other" schema, these discussions run very deep to the core of our sense of identity... perhaps just as deeply as skin tone, religion, or ethnicity.

I'm both more and less confused by this "religious issue" than the average US citizen of European descent. While I am not unfamiliar with terms that once were -- or have now become -- perjoratives, I am so unused to hearing those which denigrate or stereotype people of my own beliefs that I am surprised, stunned, and always caught unawares when they cross my ears. Sometimes the remark takes some explanation -- what is its origin? what is the stereotype that it reinforces? Most often, the speaker is either unaware of the potential offensiveness of his remark -- or that I am of the population described by those words.

Still, it is up to the speaker to intend offense -- and it is up to the listeners to interpret the intent of those words as offensive. For me, offense is intimated more often by context than by the words themselves. An otherwise innocuous word or phrase that is sneered and overemphasized can be more offensive than the "bluest" words I can imagine (I came of age during the era of the Watergate scandal -- a time when "expletive deleted" became, itself, an expletive); conversely, I have heard some of our society's most-hateful epithets used with what could have passed for brotherly endearment between people in the usually-offended community.

But, back to diabetes...

It's long been my belief that as medical science learns more about the causes of each type of glucose metabolism disorder, and how different each can be from the other, the words "diabetes" will become about as useful and specific a diagnosis as "he's not feeling well tonight" -- and "diabetic", no more useful a description than "brunette". Our doctors will diagnose something that may include a disease vector -- or an adipose-related lipokine -- activating a specific spot on a specific gene or set of genes, resulting in a specific change in the structure of secreted insulin, either causing receptor rejection (insulin resistance) or causing an autoimmune cascade.

I'm not sure just when this will come about -- only that it will come about. Sometime. Possibly within my lifetime. Hopefully within yours.

Still, just as today we identify -- and are identified -- by both general and specific details of our genetic, national, and religious origins, we will continue to be identified by the general, as well as the specific, details of our disordered glucose metabolisms. "Diabetics", "People With Diabetes", "Sugarpeople", "Beetussiz", whatever...

Now, whether or not those "d-words" become as offensive as today's religious and racial perjoratives... that's up to us. For me -- at least for now -- I choose not to be offended.