Social Stigma in Diabetes

Abstract

A comprehensive understanding of the social and psychological impact of diabetes mellitus is important for informing policy and practice. One potentially significant, yet under-researched, issue is the social stigma surrounding diabetes. This narrative review draws on literature about health-related stigma in diabetes and other chronic conditions in order to develop a framework for understanding diabetes-related stigma. Our review of the literature found that people who do not have diabetes assume that diabetes is not a stigmatized condition. In contrast, people with diabetes report that stigma is a significant concern to them, experienced across many life domains, e.g., in the workplace, in relationships. The experience of diabetes-related stigma has a significant negative impact on many aspects of psychological well-being and may also result in sub-optimal clinical outcomes for people with diabetes. We propose a framework that highlights the causes (attitudes of blame, feelings of fear and disgust, and the felt need to enforce social norms and avoid disease), experiences (being judged, rejected, and discriminated against), and consequences (e.g., distress, poorer psychological well-being, and sub-optimal self-care) of diabetes-related stigma and also identifies potential mitigating strategies to reduce diabetes-related stigma and/or enhance coping and resilience amongst people with diabetes. The systematic investigation of the experiences, causes, and consequences of diabetes-related stigma is an urgent research priority.

Understanding Stress Among Adults Diagnosed with Type 2 Diabetes at a Younger Age

“…Additionally, Schabert, Browne, Mosely, and Speight found diabetes-related stigma was experienced across life domains, including at the workplace and in romantic relationships [19]. The same research found that diabetes-related stigma had a significant negative impact on psychosocial well-being; therefore, the social stigma associated with diabetes may partially account for the clinically significant levels of interpersonal distress found in this study.…”

“…Furthermore, researchers experienced difficulty in the recruitment of males, minority populations, and those with low education levels. Due to the recent emergence of young adults with T2DM, the social stigma associated with T2DM, and the general difficulty recruiting minority populations (who are more likely to be diagnosed withT2DM) to participate in research, the sample size for this study is relatively small [19,21,22]. Generalizability to the larger population is therefore limited with these findings.…”

Stigmatisierungserfahrungen von Menschen mit Diabetes mellitus in der Schweiz

“…(Vishwanath 2014). Der Vorwurf, die Betroffenen würden das Gesundheitswesen unnötig finanziell belasten, wie auch die Verwechslung mit Drogenabhängigen bestätigen Aussagen anderer kürzlich erschienener Studien Schabert et al 2013).…”

“…Gesichertes Wissen ist entsprechend gering (Schabert et al 2013). So hält etwa eine neuere, große internationale Studie zu psychosozialen Aspekten von Diabetes lediglich pauschal fest, dass Menschen mit Diabetes davon berichten, schon einmal diskriminiert worden zu sein (Wens et al 2013).…”

“…Da davon auszugehen ist, dass die Erfahrungen von Stigmatisierung aber nicht einfach kontextunabhängig sind, sondern vielmehr von kulturellen (Schabert et al 2013), sozialen, politischen und auch rechtlichen Bedingungen mit geprägt sind, ist einer Verallgemeinerung der dokumentierten Stigmatisierungserfahrungen über den ursprünglichen Kontext hinaus mit Vorsicht zu begegnen. Vielmehr bedarf es einer Untersuchung der Erfahrungen von Menschen mit Diabetes in unterschiedlichen nationalstaatlichen Kontexten.…”