Social Stigma in Diabetes
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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.
Diabetes Australia – Vic and Deakin University provide operational funding for The Australian Centre for Behavioural Research in Diabetes, which enabled this review to be conducted. The authors’ work was independent of the funding sources. The authors have no conflicts of interest to declare.
J. Speight and K. Mosely conceived the study. J. Speight, J. Browne, and J. Schabert developed the search strategy, and J. Schabert conducted the literature search and read and summarized relevant articles. J. Schabert, J. Browne, K. Mosely, and J. Speight were all involved in the synthesization of the literature and the development of the framework. J. Schabert developed the first draft of the manuscript, and J. Browne and K. Mosely wrote additional sections of the manuscript. J. Schabert, J. Browne, K. Mosely, and J. Speight reviewed and revised the manuscript in preparation for publication. All authors approved the final version. J. Speight, as senior author, takes overall responsibility for the content of this article.
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