What is Diabetes Stigma?

The Centers for Disease Control andPrevention (CDC) defines diabetes stigma as negative attitudes, judgement, discrimination or prejudice against someone because they have diabetes. It comes from the false idea that people with diabetes made unhealthy food and lifestyle choices, which resulted in their diagnosis.

Different people can experience diabetes stigma in different ways, and its effect can range from mild to severe. Some people might feel excluded, rejected or prejudiced against. They might also feel blame, shame or guilt for their condition. Diabetes stigma is not always obvious. It can manifest in many forms, and can occur at home, at school, at the workplace and in healthcare environments. Even internal misconceptions like“it’s their own fault” or casual comments such as “should you be eating that” can cause feelings of shame and humiliation. How we think about diabetes can affect how we behave towards people who are living with it.

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Why is it important to address diabetes stigma?

We may think our language is harmless or well-intentioned, but it may not come across that way to the person concerned. When a person living with diabetes perceives judgement or dismissiveness in our words or behaviour, it can be discouraging. Stigma and discrimination can cause feelings of:

• fear
• embarrassment
• guilt
• anxiety
• increased stress levels
• low self-esteem
• depression

Because of this, people with diabetes may avoid talking about their diabetes concerns or even avoid seeking medical help for fear of further judgement. Their ability to self-manage diabetes might also be impacted. Diabetes U.K. has alarmingly noted that more than 50% of people who experience diabetes-related stigma avoid medical appointments, further jeopardising their health.

As a result, those who experience stigma are at greater risk of developing serious complications. Their health may be actively harmed by language that may have seemed harmless. And this stigma affects more than just those who have diabetes: it also impacts those around them. For instance, people who believe that individuals are responsible for their diabetes diagnosis might shift blame ontothe parents of children with diabetes.

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What Causes Diabetes Stigma?

Though diabetes stigma has many root causes, the primary one is a lack of understanding of the condition. Many people incorrectly believe that diabetes is solely the result of poor lifestyle choices. Because of this, they blame individuals with diabetes for their own diagnoses.

However, there are so many factors that can contribute to a person having diabetes which are simply outside of their control, including genetics, the environment, aging, and even socioeconomic status. If we would not blame someone for their genetics, why would we blame them for having diabetes?

Other causes of diabetes stigma include negative perceptions about obesity, particularly in relation to type 2 diabetes, and misunderstandings about the use of diabetes management technologies and dietary habits.

What Can I Do to Tackle Stigma?

Tackling diabetes stigma requires a collective effort to change how we talk and think about diabetes. Everyone can play a role in reducing diabetes stigma by fostering a more informed and supportive environment. Here are some ways you can help reduce diabetes stigma for your friends, family and wider community:

1. Educate Yourself: Understand that diabetes is a complex condition influenced by multiple factors, not just individual behaviour. Knowing that diabetes is     influenced by genetic, environmental and economic factors can help dispel     myths and reduce blame.
2. Educate Others: Promote greater awareness of the complexities of diabetes. Challenge inaccurate information and people’s attempts to oversimplify the condition’s causes. Be constructive in your criticism, as they may not have intended to be harmful!
3. Use People-Oriented Language: This type of language considers the person’s lived experience, rather than the condition. It helps you avoid judgemental language. For example, refer to someone as a "person with diabetes" instead of "a diabetic," and say they "have obesity" instead of "are obese." Avoid using "normal" to describe people without diabetes.
   Learn More about why Language Matters
4. Amplify Voices: For people who are nervous about sharing that they have diabetes, seeing others share their experiences and having them amplified by people without diabetes can be encouraging. Share and elevate the experiences of those living with diabetes through conversations, social media and other platforms. Normalising these experiences can help reduce stigma!
5. Avoid Self-Blame: If you have diabetes, it's important to recognise that it's not your fault. Internalised stigma can be as harmful as external stigma. Connect with others who share your experiences and educate  yourself about the various causes of diabetes.
6. Share Your Story: If you feel comfortable, tell your friends, family and colleagues about your diabetes experience. This can increase people’s understanding and lessen potential feelings of shame.

If you experience severe emotional distress because of diabetes-related stigma:

• Work with your GP or diabetes educator to identify how to manage it.
• Contact a psychologist or other mental health professional with an interest and expertise in diabetes

Misconceptions about diabetes are deeply ingrained in society, and addressing stigma requires an ongoing effort. By examining our biases and promoting an inclusive and supportive environment, we can reduce the blame and shame often associated with diabetes. Let's work together to support people with diabetes, enabling them to live healthier, happier lives!

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