Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland: implications for healthcare providers

Abstract

What is known about this topic• Recent studies reported that persons living with diabetes (PWD) experience stigma (discrimination and stereotypes) due to their health condition.• Surveys suggest that PWD affected by discrimination report lower scores of well-being, experience higher levels of distress and score lower in quality of life. What this paper adds• This study establishes experienced and perceived stigma of PWD living in Switzerland and thus, provides an insight into the situations in which PWD feel discriminated against and the perceived stereotypes.• Findings suggests that stigma impacts the quality of life of those PWD affected -mediated by psychological distress and depressive symptoms.• The paper gives insight into the important role of perceived stigma in this dynamic. AbstractThere is a growing body of scientific evidence that stigma represents a reality for many people living with diabetes (PWD). However, little is known about the impact of experienced stigma. Against this background, the present study aimed to establish, by means of an in-depth consideration of the situation in Switzerland, whether and how experienced and perceived stigma impact the quality of life of those PWD affected. In this cross-sectional study, an anonymous paper-and-pencil self-administered questionnaire (SAQ) was used for data collection. The SAQ drew on a qualitative elicitation study and was distributed in 2013 to the readers of a Swiss journal destined to people living with diabetes. Data were analysed using descriptive statistics and structural equation modelling. The sample included 3347 people (response rate of 16%) with type 1 and 2 diabetes, aged 16-96. Respondents who reported higher levels of perceived stigma reported higher levels of psychological distress (b = 0.37), more pronounced depressive symptoms (b = 0.33) and less social support (b = À0.22). Higher psychological distress (b = À0.29) and more pronounced depressive symptoms (b = À0.28), in turn, predicted lower quality of life. Findings suggest that stigma should be considered as an additional predictor of quality of life in PWD. Therefore, healthcare providers should support PWD's fight against stigma. Especially, social workers are called to engage in advocacy to reduce discrimination against PWD and claim equal chances for them. They are also called to develop and implement interventions to correct stereotypes about PWD.

The Use of Language in Diabetes Care and Education

“…In a study of people living with diabetes (n 5 3,347), data from a self-administered questionnaire demonstrated that perceived stigma is associated with increased psychological distress, depressive symptoms, decreased social support, and decreased quality of life (39). These assessments were confirmed in a study where stigma related to diabetes was associated with elevated A1C; increased blood glucose variability; feelings of guilt, shame, blame, embarrassment, and isolation; and negative impacts on social life (32).…”

ISPAD Clinical Practice Consensus Guidelines 2018: The delivery of ambulatory diabetes care to children and adolescents with diabetes

“…Difficulties in admission to schools or universities have forced many children to hide their diabetes. Therefore, the diabetes care team and other health care providers can play an important role in advocating for equal opportunities and where needed, special facilities (eg, access to a safe, clean place to test glucose and administer insulin, in school or workplace) for children with diabetes …”

“…Therefore, the diabetes care team and other health care providers can play an important role in advocating for equal opportunities and where needed, special facilities (eg, access to a safe, clean place to test glucose and administer insulin, in school or workplace) for children with diabetes. 93,94 Routine vaccinations should be provided for children with diabetes according to age-related recommendations. While specific recommendations vary by region, annual vaccination against influenza is also generally recommended for all individuals with diabetes above 6 months of age, 95 and pneumococcal and meningococcal vaccines are also recommended.…”

Qualitative Exploration of Experiences and Consequences of Health-related Stigma among Indonesians with HIV, Leprosy, Schizophrenia and Diabetes

“…3,18,20,59 Studies have indicated that such consequences have an impact on the overall quality of life of individuals. 2,15,59 Furthermore, they undermine the public health response and cause a negative impact on their overall effectiveness. 18,19,21 The findings of this study have several implications for public health research and practice in Indonesia.…”

“…5,14 People with different health conditions experience stigma that negatively affects their social, physical, psychological, and spiritual well-being. 2,12,15 It reduces the degree of access and uptake of health care services, causing the underdiagnosis of conditions, failing to detect mental health issues, and delaying and disrupting treatment. [16][17][18] Such consequences of stigma affect preventive and treatment measures for eliminating these diseases, ultimately hampering advancements in decreasing the burden of diseases.…”