Stigma by definition is the disapproval of, or discrimination against, a person based on perceivable social characteristics that differ them from other members of a society. Unfortunately, research suggests people with diabetes experience this stigma. The Australian Centre for Behavioural Research in Diabetes is the first national research centre internationally, dedicated to investigating the behavioural, psychological and social aspects of people living with diabetes. They started research into diabetes stigma in 2011, since then their work has been highly acknowledged. 

Main findings from one of their literature was that people who do not have diabetes assume that diabetes is not a stigmatised condition. In contrast, people with diabetes report that stigma is a significant concern to them. Studies have reported that diabetes-related stigma has had a negative impact on many aspects of psychological, social and emotional well-being for people with diabetes.

How is stigma related to Diabetes and what causes this stigma?

Diabetes-related stigma may have negative consequences for self-care and clinical outcomes, which may cause poor management of the condition itself. 

In another research paper by Schabert et al the theoretical perspective of social stigma has been explained in detail. They have talked about 5 components of conceptualization which are:

  • Categorising diabetics based on their silent character and attributes, observable behaviors required to manage the condition (e.g., food choices, injecting insulin, or taking medication) or physical characteristics associated with the condition (e.g., obesity in the case of type 2 diabetes).
  • Linking them with negative stereotypes such as being lazy or overeating etc 
  • Once linked with the negative stereotype, stigma process leads to separating to two different groups of “Us” and “Them”
  • Status loss and discrimination (e.g., being regarded as unreliable employees)

Stigma is dependent on power—social, cultural, economic, and political power differences

Sources of Stigma 

Stigma can be external, which means it comes from other people and society, or it can be internal, meaning it comes from yourself. A common misconception is that diabetes is a result of poor choices and the individual behaviour. 

The major sources of stigma have been recognised as:

  • Individuals
  • Groups
  • Communities
  • Health Professionals 
  • Person with diabetes 

Obesity and weight stigma is a common thing the health industry is trying to deal with. This stigma is related to someone’s body size, shape, or weight – also heavily contribute to diabetes stigma, especially related to type 2 diabetes. Some people experience both type 2 diabetes and weight stigma.

 

The image below from the above mentioned paper explains the experiences related to the stigma and the consequences of that on the person with diabetes in a very explicit manner. 

The consequences of our smallest action can be way more complex than we can even think of.

What can you do to address diabetes stigma?

Our words have more power than we think. Both the groups, people with diabetes and not with diabetes have the equal responsibility to end this stigma and reduce the prejudice surrounding the condition.

Here are some ways you can help in the same.

  • The main factor is dealing with the disease itself, using strategies such as public health initiative to initiate early detection and working towards prevention of this disease.
  • Using social media or other mediums to spread education and awareness about the topic for people who are the source of stigma.
  • Use of positive and non judgemental language. For example, use “person with diabetes” rather than “diabetic”.
  • Don’t force someone with diabetes to eat more than they wish or for desserts, as that may be a trigger point for some.

For persons with diabetes 

  • Stop blaming yourself. There are a number of factors causing diabetes that are not in your control. Be kind to yourself!!
  • Aim to reduce the emotional impact of stigma by speaking about it or seeking counselling services or attending peer support groups. 
  • Share your stories and experiences to spread awareness. If possible, stand up and point out the unwanted behaviour by others. 

 

Small steps in the right direction can help us overcome the diabetic stigma. Let’s work together in understanding diabetes-related stigma and to mitigate this negative phenomenon in diabetes.

References:

  1. Schabert, J., Browne, J.L., Mosely, K. et al. Social Stigma in Diabetes. Patient 6, 1–10 (2013). https://doi.org/10.1007/s40271-012-0001-0
  2. https://acbrd.org.au/social-stigma-in-diabetes/
  3. Diabetes stigma and discrimination: finding the right words. https://doi.org/10.1016/S2213-8587(18)30235-3
  4. https://www.diabetesaustralia.com.au/news/the-diabetes-stigma/




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