Lessons learned: Challenges in interpreting diabetes concepts in the Navajo language.

Communication about diabetes presents a challenge for indigenous populations experiencing increasing rates of type 2 diabetes. In translating simple terms related to diabetes from English to Navajo and transforming information into acceptable and useful forms for patients from traditional backgrounds, Navajo interpreters are faced with many challenges. The Navajo language was originally unwritten, and like most native languages, the grammatical structures and constructs are very different from those of Latin-based languages. This commentary highlights the lessons learned during the process of translating information about diabetes into Navajo during the course of the controlled randomized study on the “Effect of Navajo Interpreters on Diabetes Outcomes” and may provide a template of considerations for other ethnic groups when translating terms relating to diabetes. Briefly, four translators initially recorded an oral Navajo translation of the Michigan Diabetes Knowledge Test (1). The taped version was translated back into written English by a Navajo language expert, who then prepared another Navajo version. The revised translation was verified with selected elderly community members and with a committee that included nurses, dieticians, health educators, a traditional medicine practitioner, a community elder, and a patient with diabetes. The original translators and the Navajo language expert together reached a final consensus. While the translators were completing the Navajo translation, they received training about the disease process of diabetes and medical translation. All interpreters passed both Navajo and English proficiency testing.