Diabetes is so much more than just a medical condition. For the millions of people around the world who live with it, it’s also a complex reality that affects every aspect of their daily lives.
However, society often has an inaccurate and over-simplistic view of diabetes, considering people with diabetes as responsible for their condition because of their lifestyle choices. This “diabetes stigma” takes many forms and can manifest in misconceptions, negative judgments of certain behaviours (e.g., “Shouldn’t you be avoiding sugar?”) or rejection (e.g., not inviting a child with diabetes at a birthday party).
In 2011, the International Diabetes Federation called for global action to fight against this stigma and end discrimination against people with diabetes. A recent article published in a scientific journal summarizes what progress was made, what challenges are yet to be overcome and the odds of achieving these goals.
Bringing attention to the problem
Over the past 10 years, stigma associated with diabetes and its widespread impact have been increasingly supported by solid evidence. A study carried out in 17 countries shows that around 20% of people with diabetes (all types) have been discriminated against because of their medical condition.
What’s more, most people with diabetes, regardless of the type (e.g., type 1, type 2, LADA) and environment, have experienced some form of stigma associated with their condition. This can lead to negative effects on their mental health, social relationships, behaviours and physical health.
Medical appointments are often a major source of stigmatization, as they often call for blame and judgment on the part of healthcare professionals (e.g., when the person fails to meet targets). In fact, this stigmatization can even have a negative impact on the quality of care, leading patients to avoid discussing certain subjects related to their condition or to miss medical appointments.
The media (e.g., movies, TV shows) and organizations (e.g., local, international) also have their share of responsibility in disseminating stigmatizing images and messages that convey the idea that people with diabetes are to blame for how they end up with and manage this condition. They also often fail to explain the different types of diabetes, which contributes to increased confusion about the reality and challenges of living with diabetes.
We now know how this stigma can also stand in the way of access to support and funding for diabetes care (e.g., access to new technologies), programs and research. Negative biases can influence funding choices and discourage community involvement. Stigma can also reduce the media visibility of diabetes-related initiatives.
Breaking it all down into one figure
The article citing the study presents a figure to help better understand the sources, experiences and consequences of diabetes stigma. Here’s a simplified version:
Reducing stigma: challenges and opportunities
Reducing the stigma associated with diabetes is a complex challenge that requires a comprehensive, evidence-based approach. While there is increasing evidence of this stigma, it’s still difficult to understand how to curb it effectively.
Diabetes organizations are increasingly aware of and committed to eradicating this stigma. They incorporate strategies to reduce stigma in their programs, services and campaigns (e.g., by emphasizing the need to change the way people talk about diabetes, by funding research into stigma).
We can learn from the successes achieved in the fight against stigma in other areas of health, such as HIV and mental illness, which can help us shape future diabetes-specific strategies (e.g., by developing a global consensus).
The power of individual voices
People with diabetes have considerable power to change perceptions and fight the stigma associated with their condition. There is over half a billion people worldwide living with diabetes (of all types); their collective voice is powerful.
“If diabetes were a country, it would have the third-largest population in the world.”
Shared experiences, mutual support and advocacy for concrete measures are essential to raise awareness of the reality of diabetes and to eradicate the stigma.
To put an end to it, everyone must get involved. Healthcare professionals need to be understanding and let go of judgments, the media need to change the way they talk about diabetes, and organizations need to integrate stigma-reduction strategies into everything they do.
Together, by recognizing and respecting the lived experiences of people with diabetes, we can create a stigma-free future and improve the lives of people who live with this condition around the world.
References :
- Speight, J. and Holmes-Truscott, E. (2023). Challenging diabetes stigma starts and ends with all of us. The lancet. Diabetes & endocrinology 11(6), 380-382. doi:10.1016/S2213-8587(23)00084-0
- Nicolucci, A. et al. (2013). Diabetes Attitudes, Wishes and Needs second study (DAWN2™): cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabetic medicine : a journal of the British Diabetic Association 30(7), 767-77. doi:10.1111/dme.12245
Writen by: Sarah Haag, RN. BSc.
Reviewed by:
- Rémi Rabasa-Lhoret, MD., PhD.
- Anne-Sophie Brazeau, P. Dt., PhD
- Nathalie Kinnard, scientific writer et research assistant
- Asmaa Housni, Master’s student in nutrition
- Sonia Fontaine, Domitille Dervaux, Michel Dostie, patient partners of the BETTER project
Linguistic revision by: Marie-Christine Payette
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