Four in five adults with diabetes experience stigma and one in five experience discrimination related to their condition, international experts say.
The findings are from an International Consensus, published in The Lancet Diabetes & Endocrinology [link here], by 51 experts from 18 countries who aim to end diabetes stigma and discrimination, including in the clinical setting.
The consensus statement titled Bringing an End to Diabetes Stigma and Discrimination: An International Consensus Statement on Evidence and Recommendations describes diabetes stigma as being driven primarily by blame, perceptions of burden or sickness, invisibility and feelings of fear or disgust.
Stigma is also facilitated by media and public discourse, health organisations and health professionals, as well as cultural and social norms, policy, and law.
“There is an inaccurate, and overly simplistic, societal view that people with diabetes are to blame for their condition and its complications—this societal view is a key driver of diabetes stigma,” according to the document.
“People with diabetes who experience diabetes stigma in healthcare settings are more likely to: have higher HbA1c and/or severe hypoglycaemia; experience lower quality healthcare consultations; disengage from healthcare; and experience delayed access to treatments, technologies, and specialist care.”
The experts go on to advise: “Health professionals supporting people with diabetes need to ensure their practice is stigma-free.
“Training in stigma-free consultation skills needs to be implemented early in clinical training and demonstrated through continuing professional development and accreditation; and professional bodies need to include stigma-free practice in their professional standards.”
Change the narrative
They call on collective leadership to proactively challenge, and bring an end to, diabetes stigma and discrimination by changing the narrative around diabetes, as well as supporting research, initiatives, and policies that will improve quality of life.
The Australian-led effort to end stereotypes and prejudice has received global support, with a pledge – which received unanimous consensus from the expert panel – endorsed by nearly 300 organisations in more than 100 countries.
Professor Jane Speight, co-lead of the International Consensus, said the group hoped to encourage the public to challenge stigmatising language and jokes about diabetes, as well as to condemn discrimination against people with diabetes when they see it.
“[Diabetes stigma] can lead to depression, anxiety, and emotional distress. It can lead them to conceal their condition in public, which can affect how well they manage it. It can also have impacts on their personal, family, social and professional lives,” said Professor Speight, founding director of the Australian Centre for Behavioural Research in Diabetes.
“Stigma can also have a negative impact on public and government support and funding for diabetes research, prevention, care, and treatments.
“We invite every individual and every organisation across the world to take the Pledge [link here] and play their part in the change needed to end diabetes stigma and discrimination.”