Are weight stigma and diabetes stigma barriers to diabetes care in adults with type 2 diabetes?

Findings from a US study show the potential impact of both experienced and self-stigma.

By Chantelle Gallow

New research led by Professor Rebecca Puhl (University of Connecticut) explores the potential impact of weight stigma and diabetes stigma among adults with type 2 diabetes. Such stigma may include feeling or being judged, blamed, or treated differently by others due to diabetes or weight.

The researchers, including the ACBRD’s Prof Jane Speight, looked at the links between stigma and:

    1. behaviour: diabetes self-care,
    2. beliefs: self-confidence to manage diabetes,
    3. emotions: diabetes distress, and
    4. support: perceptions of and access to health care.

In this study, 1227 adults with type 2 diabetes living in America completed an online survey. On average, they had been living with diabetes for 9 years. Around 75% had a body mass categorised as ‘overweight’ or ‘obese’.

Overall, the results show that stigma is associated with a person’s behaviour, beliefs, emotions, and support. Specifically:

    • self-stigma for diabetes and weight are both associated with diabetes distress. That is, those who blame themselves for their weight or their diabetes also report greater distress about living with diabetes;
    • self-stigma for diabetes is also linked to lower diabetes self-care and confidence.
    • experienced diabetes stigma is related to less frequent health screening (e.g. HbA1c, eye checks);
    • experienced weight stigma and diabetes self-stigma are both associated with lower quality interactions with healthcare professionals;
    • positively, there is no association between self-stigma (weight or diabetes) and seeking professional healthcare.

These important findings highlight, for the first time, the potential negative consequences of both self-stigma and experienced stigma related to weight and diabetes among adults with type 2 diabetes. They also show that health professionals may play a key role in tackling both diabetes and weight stigma.

The authors call for more research on the role of stigma in diabetes and how reduce it.

To read more research about the role of stigma in diabetes, check out the ACBRD website.

Diabetes stigma is the focus of campaigns for National Diabetes Week (11-17 July) in Australia. You can read more about the Diabetes Australia campaign here, and the Diabetes Victoria campaign here.

Full article: Puhl RM, Himmelstein MS, Hateley-Browne J, Speight J.  Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care. Diabetes Research & Clinical Practice, 2021; 168: 108387.

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