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.
González et al. (2026) studied this question.