For the Chinese among us, the phrase 糖尿病 (táng niào bìng), or diabetes, is probably no foreign term to most of us.

Even though it quite literally means “sugar urine illness”.

In Singapore, around one in three people are at risk of developing diabetes during their lifetime, so it’s no surprise that most of us may be familiar with the condition.

And for the trilinguals (or not) among us, you might know that diabetes is also written as 糖尿病 and is pronounced as tonyobyo. The characters also have the same literal meaning as the Chinese characters.

As the name suggests, diabetes is often thought of as a condition that causes patients’ urine to attract ants since this was apparently what doctors observed in the past.

However, it’s actually not true for a lot of diabetic patients. Yup, I’m not kidding you. Many diabetic patients actually don’t pass glucose in their urine.

With that, Japanese doctors are currently speaking of changing the name of diabetes in the Japanese language to something that more accurately reflects the condition and reduces the stigma that individuals with diabetes may face.

Stigma Surrounding the Term “糖尿病”

When speaking to The Straits Times, Dr Hideaki Iwaoka, a doctor from the Japan Diabetes Society, pointed out that the character 尿 literally translates to “urine”, which carries a negative connotation.

In particular, it paints diabetes patients as “dirty” and unkempt, leading to a negative stigma towards the disease.

Dr Yutaka Seino, the chairman of the Japan Association for Diabetes Education and Care, echoed similar sentiments and said that several patients felt like the stigma has led to them facing discrimination in the job market.

The association also carried out a survey regarding the phrase “糖尿病” and polled around 1,100 patients between November 2021 and September this year.

According to the survey, nine out of ten patients in Japan indicated that they had been affected by discrimination due to the negative connotation that their illness’ name carries.

The phrase also suggests that the illness is caused by sluggish and poor lifestyle habits, which makes them feel ashamed or inadequate.

Furthermore, 80% of respondents were in favour of changing the term representing “diabetes” in Japanese.

Types of Diabetes and Impact of Changing its Name in Japanese

For those familiar with diabetes, you will know that there are two types: Type 1 and Type 2.

In both cases, patients experience high blood sugar levels over a prolonged period, which can eventually cause complications such as heart disease, kidney disease or blindness.

For Type 1 diabetes, which is usually diagnosed when patients are young, patients experience high blood sugar due to the pancreas’ inability to produce insulin. This hormone controls blood sugar levels.

For Type 2 diabetes, which is usually developed when patients are older due to their lifestyle, occurs when patients’ body rejects the insulin that their pancreas produces.

Other hereditary and genetic factors, such as insulin deficiency, may also result in diabetes.

According to Dr Iwaoka, around 2% of the ten million diabetes patients in Japan have Type 1 diabetes.

Hence, the name change will help the public understand that there are other causes for diabetes other than patients’ lifestyle habits.

For Dr Iwaoka, his recommendation for the new Japanese term for diabetes is “高血糖症”, which is pronounced as “kokettosho”.

The characters literally mean “high blood sugar disease” in English and can help eradicate the negative stigma while encompassing the actual meaning of the illness.

The characters also have the same meaning in Chinese.

Not the First Time Japan Has Changed Names of Illnesses

Before changing the term for diabetes, Japan also changed the name for other medical conditions, such as schizophrenia and dementia, to help reduce the stigma.

Back in 2002, Japan changed the term for schizophrenia in Japanese. The original term, “精神分裂病” (pronounced as seishin bunretsubyō), could be translated into English as “split-mind disease” and was controversial due to the negative connotations and discrimination that it caused.

The new term, “統合失調症” (pronounced as tōgō shicchō-shō), means “integration disorder syndrome”.

However, despite having similar characters, schizophrenia is still commonly known as 精神分裂症 (jīng shén fēn liè zhèng).

Two years after that, in 2004, Japan also changed the name of dementia from “痴呆症” (pronounced as “chihosho”) to “認知症” (pronounced as “ninshisho”), changing the meaning from “retarded illness” to “cognitive illness”.

At that time, the Health Ministry explained during a panel that the former term was “derogatory” and was unable to “accurately reflect the loss of cognitive functions, and as such hinders early diagnosis and treatment”.

“Even as their memory impairment progresses, elderly people with dementia still have feelings and pride. They have strong anxiety towards the outside world, and acutely feel frustration, loss, and anger.

“For this reason, it is important to use a term that preserves their dignity as a basis of care,” they highlighted.

A similar change occurred in Singapore around a decade ago when people started referring to dementia as 失智症 (pronounced as shī zhì zhèng) instead of its previous name, 痴呆症 (chī dāi zhèng). This changed its meaning from “imbecile/stupid disorder” to “cognitive loss disorder”.

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