How did "sugar" come to mean "diabetes"?

March 6, 2010 8:32 AM

So what do you know about "sugar", "sugar diabetes", or "the sugar" being used as synonyms for "diabetes"? And how did that meaning come to be, exactly?

A friend's Facebook post has piqued my curiosity about people using "sugar" (or phrases that include the word "sugar") as a synonym for diabetes mellitus. This usage is pretty alien to me personally, but according to this post on Everything2, it's used widely in eastern North America, in Canada as well as in the South.

However, a preliminary Google and Wikipedia search yields little, so I'm wondering if any of you have either firsthand knowledge of people using "sugar" in this way (and who/where), or can point me to resources either online or offline, such as books or articles by linguists, that could elucidate the range, origins and/or evolution of this usage. I'm especially interested in how "diabetes" evolved in folk usage to "sugar", and what the stages were along the way. Did it have multiple, independent origins, or did it start in one small area and spread everywhere else? Is there a class or ethnic dimension? I'm also interested in the firsthand accounts, as that could help build a picture (albeit anecdotal) of how widespread this usage really is, or was.

posted by skoosh to Writing & Language (32 answers total)

My grandmother used the terms "sugar" or "sugar diabetes", way back in Eastern KY. She was born in 1919 or 1920 (we had varying stories). People living out that way still do use that term, from what I see at work in medical histories. I'd think "sugar" might be an older usage than "diabetes mellitus" in English, actually, although it's just a guess. Diabetics can have sugar in their urine and that used to be one of the main tests for the disease
posted by dilettante at 8:43 AM on March 6, 2010

My grandparents and their peers use this terminology in Ohio.
posted by runningwithscissors at 8:46 AM on March 6, 2010

My mother (from New York City, born in 1940) called it sugar diabetes.
posted by deadmessenger at 8:50 AM on March 6, 2010

My mother used the phrase "sugar diabetes." She was from the Midwest (Iowa, to be more precise).

(She also used the phrase "salt diabetes," which I've never heard anybody else use. I have no idea what that meant to her or what she was trying to convey. I've since read that it was/is a layperson's term for describing hypernatremia associated with uncontrolled diabetes, so perhaps that's what she had in mind.)
posted by arachnid at 8:51 AM on March 6, 2010

My parents (Eastern Ohio/Northern WV) who are in the late 60s and their siblings (70s+) all use this slang interchangeable with diabetes. Anecdotally they seem to use "sugar" more amongst themselves and use "diabetes" when talking to someone younger or to someone they don't know as well.
posted by mmascolino at 8:53 AM on March 6, 2010

If it helps at all, in Armenian you say 'I have sugar' to mean diabetic.

(Used to get out of pressure to eat sweets.'
posted by k8t at 8:56 AM on March 6, 2010

I'm from Sarajevo, Bosnia and in Serbo-Croatian, we say the equivalent of "sugar diabetes" colloquially. Additionally, the word I learned for diabetes in Hungarian is "cukorbaj," which breaks down as "sugar trouble" or "sugar problem." Cukor = sugar and baj = trouble.

So I'd suspect this isn't a regionalism in English as much as a reflection of how diabetes was referred to in many languages.
posted by Dee Xtrovert at 8:58 AM on March 6, 2010

My grandparents (Arkansas/Army/Texas; caucasian, born in the early 20s) used "sugar diabetes" or "the sugar diabetes" and, at least for my grandmother, it was practically one word. I'm not sure I ever heard her just say "diabetes" or use the term "diabetic" even when discussing my grandfather's condition with medical professionals or my dietician aunt's work in dialysis centers.

I am fairly confident that I could use the phrase with at least anyone around my age (late 30s) or older who grew up Southern or had lived in the South long enough and they would know what I meant and also recognize it as an old-fashioned terminology.
posted by Lyn Never at 9:06 AM on March 6, 2010

I have sometimes spoke with patients that call DM some variant of "sugars". They are usually older, occasionally either 1st or 2nd-generation immigrants from the southern part of the US, and almost always from lower SES. Or more commonly, when doing a family history they will tell me of their parents of grandparents who had "sugars".
posted by meehawl at 9:21 AM on March 6, 2010

I grew up in Queens, NY, have moved around the country a fair bit, and now live in Oakland, CA. I've only ever heard the term "sugar" used to refer to diabetes by my neighbors in the African-American community.

I suspect this may be related to the Southern angle related in replies above.
posted by Pirate-Bartender-Zombie-Monkey at 9:21 AM on March 6, 2010

In Germany, people call it Zucker (sugar) or Zuckerkrankheit (sugar disease). This is a layman expression mainly used by older people.
posted by The Toad at 9:25 AM on March 6, 2010

Great answers so far! Okay, so far we've established that the "sugar"="diabetes" usage is not limited to English, or even Indo-European languages. So that's a pretty strong indication of multiple independent origins, I'd say. I'm thinking that since "diabetes mellitus" literally means something like "excessive discharge of sweet urine" in medical Greek ("diabetes"="excessive urination" (literally, "siphon"), and "mellitus"="sweet" or "honeyed"), in the midst of the transition from referring to the disease as "diabetes mellitus" to simply "diabetes", the word "sugar" got applied as a way of distinguishing diabetes mellitus from other kinds of diabetes. Not many people know what "mellitus" means, so one could substitute the word "sugar" instead. And apparently they did so, in many different languages. And then from "sugar diabetes", we could get "*the sugar trouble", or "the sugar", or simply "sugar." In the meantime, there's a parallel development from "diabetes mellitus" to "diabetes" – possibly with "sugar diabetes" as an intermediate term?

Sorry for answering my own question, but I definitely needed to get that input about usage in other languages before getting to this point. And of course, this is still just amateur speculation at this point. If anyone knows of an actual study or research paper about it, that would be awesome.
posted by skoosh at 9:38 AM on March 6, 2010

It was also traditionally used in rural upstate New York and New England, including by country doctors when talking to patients. The actual incidence of diabetes where I grew up seems (to me) to be less common now that there is more migration.
posted by jgirl at 9:44 AM on March 6, 2010

Oh, and it looks like the "sugar" usage is gradually getting edged out in rural, lower-prestige dialects by the "diabetes" term from higher-prestige standard dialects. Used more often by older, more rural people, understood by middle-aged people but also recognized as an "old-fashioned" term, not used very much by younger people (just judging from the total lack of first-person "I say 'the sugar' to mean diabetes" responses).

What's fascinating to me is that, according to The Toad's comment, this is a cross-linguistic phenomenon – "Zuckerkrankheit" is apparently being replaced by "Diabetes" in German as well.
posted by skoosh at 9:53 AM on March 6, 2010

I don't know for sure but I have always assumed (and you know how they say to never assume) that it went something like this:

Doctor (to newly diagnoses patient): You are diabetic.
Patient: What does that mean?
Doctor: Your blood glucose is too high.
Patient: What's glucose?
Doctor: It's like sugar in your blood.
The patient then leaves the doctor's office and says to anybody who cares to listen: I have sugar diabetes.

If somewhere down the road that same patient loses his toes to diabetes, he might then say, "I got sugar diabetes and the sugar settled in my toes and I had to get them cut off."
posted by Uncle Chaos at 10:08 AM on March 6, 2010

When I was growing up (Detroit area) almost all the adults I knew called it "sugar diabetes" (and a lot of them used the Wilford Brimley pronunciation "diabeet-us"). Some of the African-American adults I knew called it "sweet blood" or "the sugar." My father-in-law (rural Georgia) sometimes calls it "sugar" ("Would you bring me my sugar medicine from the 'fridge?").
posted by Oriole Adams at 10:26 AM on March 6, 2010

When asking elderly relatives (70s-100s) back in eastern Canada (Nova Scotia) how family members from past generations died they would state they had "had the sugars". A few of their decedents still refer to it as that but I am unaware if that is used culturally there anymore.
posted by beautifulcheese at 10:58 AM on March 6, 2010

Interesting addition to this question is the hybrid term "sugarbetes", heard on the 11/3/2007 Brian Williams/Feist episode of Saturday Night Live. Kenan Thompson plays a nanny who is commenting on the costumes kids wear today on Halloween:

"The other night, a girl came by my house dressed as a nurse with her blussums exposed. I told her, "Don't you be defaming nurses! Nurses are heroes! I had one of them take good care of me, when my sugarbetes flaired up. And you know, if it wasn't for nurses, Barbara Birmingham might only have one foot!"

So. I'm guessing that Kenan Thompson heard people in his life using the phrase "sugar diabetes" and conflated the words.
posted by inturnaround at 11:34 AM on March 6, 2010

I'm not sure you should fix so strongly on the theory that this derives from the "mellitus" part of diabetes mellitus; after all, the condition is a problem with the metabolism of glucose, and the term could simply be purely descriptive in origin.

Just to confirm what other posters have indicated, in the Mid-Atlantic South, I would definitely associate the usage with older speakers of low-prestige sociolects, especially rural people and AAVE-speakers.
posted by strangely stunted trees at 11:47 AM on March 6, 2010

My relatives in India call it "sugar" too. They all know at least a bit of English (most of them speak it fluently), so they call it "sugar" in English. I don't think I've ever heard anyone call it by the Hindi word for sugar.
posted by asras at 11:57 AM on March 6, 2010

Pretty much a slang term, much like "slim", used in central Africa to refer to AIDS.
posted by yclipse at 12:28 PM on March 6, 2010

Before the science was better, older folks' diabetes management avoided sweets, instead of carbohydrates. I remember my grandmother talking about her sugar-- middle-class New England white woman by way of Newfoundland.
posted by fairytale of los angeles at 12:30 PM on March 6, 2010

Hi, Type II diabetic here.

It really really really sounds like you're over thinking this. The inability to properly deal with glucose, ie. sugar, is the problem with diabetes, so it doesn't seem like a stretch to see the term "sugar" used as a synonym. Glucose is a medical term, unused by many. Sugar is a familiar word and term.

Also, what Uncle Chaos andfairytale of los angeles said, the latter of which I think still applies a today. Most people don't really have the first clue about diabetes, but always seem to get hooked on the sugar aspect i.e. "OMG, you can't have cookies EVER?! I WOULD DIE?!"

Interesting note: was sitting in a room with other diabetics in Savannah, GA recently. Most of them were older than me, say anywhere between 45 and 60. Our health insurance copy was showing us various ad campaigns to get diabetics interested in several programs targeted towards health. One of the campaigns used the term "the sugar". We universally hated that term. The last thing we wanted to be reminded of is sugar.
posted by Brandon Blatcher at 12:46 PM on March 6, 2010

Datapoint: sockersjuka (sugar sickness) in Sweden. Diabetes has more or less replaced this phrase.
posted by Iteki at 1:24 PM on March 6, 2010

So diabetes mellitus was named way back when by some Greek guy, but that doesn't mean everyone suddenly had that Greek phrase added to their vocab. I'm having a hard time formulating what I want to say, partly because it's more a gut feeling than anything, but it sounds to me as if you're thinking these poor people out in the sticks were just not clever enough to use the proper terminology when they heard it from their doctors. I'm just not sure that's how it worked at all. I mean, it's possible that "the sugars" etc is the baseline, not diabetes mellitus, that is was thought up to describe personal observation, just as DM was thought up. Look at all the other languages represented here that use the same/similar phraseology.

It seems to me that people who maybe didn't go to the doctor a lot (isolated, poor, rudimentary professional medicine available if any at all), but who were clever enough to see a pattern--and we're all pattern recognition monkeys, no?--put two and two together and realized that those folks who have the sugary piss actually have a disease. It's the sugar disease. Sugar sickness. Sweet urine. Diabetes mellitus. it's all the same: It's descriptive.

Now we're in an era when language/usage is becoming more homogeneous and official medical terms more common, so the "Correct Term" is supplanting the "common one."

I have no concrete evidence to support this view, though. It would be interesting to know for certain. It's language, though, so . . .
posted by miss patrish at 2:41 PM on March 6, 2010

Now we're in an era when language/usage is becoming more homogeneous and official medical terms more common, so the "Correct Term" is supplanting the "common one.".

It's already been demonstrated that variants of terms like "the sugars" and "sugar trouble" are the accepted words for diabetes in many languages and though I am sure many of them now *also* use the term "diabetes," this is probably simply because it sounds more "medical" and is, in all fairness, a bit more precise than "sugar trouble." But it's kind of a shame that the old correct term has been replaced by a new correct term that makes less sense to laymen.
posted by Dee Xtrovert at 3:03 PM on March 6, 2010

Here it is being used in 1884 in an ad for snake oil, and in 1880 by a doctor.
posted by The corpse in the library at 3:51 PM on March 6, 2010

Used more often by older, more rural people, understood by middle-aged people but also recognized as an "old-fashioned" term

It's also used in Spanish (azúcar), in the same way you describe.
posted by clearlydemon at 5:07 PM on March 6, 2010

The Toad: In Germany, people call it Zucker (sugar) or Zuckerkrankheit (sugar disease). This is a layman expression mainly used by older people.

The Icelandic word for diabetes mellitus is sykursýki, which is the same as the German formulation, but this is also the technical medical term for it. Diabetes is not used in Icelandic.

Also, "sugar sickness" is apparently well understood enough for The New York Times to use that term in a headline (though it's also a play on words).
posted by Kattullus at 6:17 PM on March 6, 2010

Check out the Wikipeida article on diabetes, which goes over the history of the disease. Every culture seems to have named the disease based on it being related to sweetness. From there it's easy to see how "the sugar" name and all its variants would come about.
posted by Brandon Blatcher at 8:42 PM on March 6, 2010

One way of diagnosing diabetes back in the day was to take some of the patient's urine and pour it on a relatively clean, nonporous surface outside, like a back porch.

If puddle drew ants and/or flies = puddle had sugar in it = "sugar diabetes." No ants = no sugar in the urine.

on preview: what the Wikipedia article says.
posted by lambchop1 at 8:54 PM on March 6, 2010

My grandparents grew up in upstate NY and always said that people had "the sugar". Also my FIL had diabetes and grew up in New England - he always told people he had "sugar". Both of these groups would now be in their 80s-90s, and most of them would say diabetes if they are talking to a medical professional, but still prefer to talk about their "sugar" when talking with family or friends.
posted by garnetgirl at 7:05 AM on March 7, 2010