P-83: Language matters in Brazil: from terminology guidance to systems change in pediatric diabetes care
M Barone, H Pedrosa, Á Trapé, D Ramos, E Prates, M Silveira, P Ripoli, R WieselbergAbstract
Introduction
Stigma in diabetes affects engagement, mental health, and outcomes in children and adolescents. Language is a key, modifiable driver of stigma, influencing not only terminology but also relationships and care environments.
Objectives
To describe the implementation and evolving scope of Brazil’s national “Language Matters” initiative, from terminology guidance to systems-oriented change.
Methods
Implemented since 2022, following expanded second edition (2025), co-created by people living with diabetes, healthcare professionals, and other stakeholders. Dissemination included academic curricula, professional training, and policy dialogue. Content was also incorporated into a national academic book on stigma-free nutrition for health professional education. This description is informed by implementation experience, including adoption, educational reach, and stakeholder feedback.
Results
The initiative engaged over 60 partner organizations across public, private, and civil society sectors. Guidance was incorporated into training programs and referenced in a national residency examination. Adoption included implementation by a state health department, with adaptation into local materials and expansion across municipalities. The initiative contributed internationally through participation in a global diabetes stigma summit and a multinational scientific publication. Stakeholder feedback suggests increased awareness of stigma, shifts in communication practices, and greater inclusion of people living with diabetes in care discussions. The initiative evolved across three phases: terminology, communication, and systems integration.
Conclusions
The Brazilian “Language Matters” initiative shows how addressing language can drive cultural and systemic shifts in diabetes care, highlighting the potential of community-driven approaches to influence education, policy, and practice, and the need for ongoing evaluation and context-sensitive implementation to sustain impact in pediatric diabetes.