A multi-country review explores what type 2 diabetes stigma looks like in healthcare settings, why it happens, and why it matters
When you live with type 2 diabetes (T2D), you rely on healthcare professionals for support and guidance. Your healthcare team play an important role in your diabetes care. But we also know that healthcare settings can sometimes be a source of stigma. Many people with diabetes have shared that they’ve experienced blame or judgment during healthcare visits.
Recent international consensus recommendations to end diabetes stigma state that healthcare professionals should ensure their practice is “stigma-free”. The challenge is that, until now, we haven’t had a clear understanding of how diabetes stigma actually shows up in healthcare settings. This makes it difficult to translate these recommendations into real changes in practice and policy.
To help address this gap, we partnered with The diaTribe Foundation to review the available evidence on T2D stigma in healthcare.
The study
This review was led by Emmanuel Ekpor as part of his PhD research on understanding and addressing T2D stigma in healthcare.
We searched published research to find studies that explored T2D stigma in healthcare settings. We found 61 studies from 32 countries. Using the Health Stigma and Discrimination Framework, we looked at:
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- What T2D stigma looks like in healthcare settings
- Why it happens
- How it affects people living with T2D
What did we find?
What does T2D stigma look like in healthcare settings?
People with T2D described many forms of experienced stigma during healthcare visits. Qualitative studies showed that some people felt blamed for developing diabetes or for having high glucose levels. Others reported feeling judged as lazy, unmotivated, or unwilling to follow medical advice. Surveys of people with T2D and health professionals showed that:
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- 22%–89% of people with T2D felt healthcare professionals saw them as lacking self‑care knowledge
- 11%–61% of people with T2D felt judged by healthcare professionals
- 42% of health professionals said they held stigmatising attitudes toward people with diabetes
- 44% of health professionals said they witnessed other health professionals making negative comments about someone with T2D
Stigma was shown through tone, body language, and specific words. For example, terms like “self‑inflicted” or “diabetic”. Stigmatising healthcare practices included dismissing people’s efforts and concerns, denying healthcare services, and providing poor quality care because of assumptions about their condition.
Some people also described anticipated stigma. That is, they expected and worried about being criticised, blamed, or judged before appointments. Over time, these experiences sometimes led to internalised stigma. That is, where people accept these negative messages and blame themselves.
Why does this happen?
The review found that stigma in healthcare is driven by beliefs, attitudes, and systems that reinforce negative views about T2D.
Key factors included:
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- Negative stereotypes: Some healthcare professionals report inaccurate beliefs about people with T2D. For example, assuming people with T2D are not motivated or not following advice. These misconceptions contributed to blaming people for their diabetes.
- Negative emotional reaction: Some healthcare professionals reported feelings of frustration, irritation, or disappointment when caring for people with T2D, which can negatively influence how they communicate.
- Gaps in knowledge: Limited understanding of the complex biological, social, environmental, and psychological factors that contribute to T2D can lead to oversimplified and judgmental views of the condition.
- Simplistic care models: Healthcare systems often focus heavily on outcomes such as HbA1c levels and body weight. When these targets are not met, people may be blamed or judged rather than supported.
- Media misrepresentation: Media messages frequently describe T2D as a “lifestyle disease” caused by “poor” choices. These simplified narratives can reinforce stigma in healthcare settings.
What are the consequences?
People with T2D reported a range of emotional impacts from stigma in healthcare. They described feelings of shame, guilt, embarrassment, frustration, and low self-esteem. Some said stigma made it harder to look after their diabetes. Some delayed medical appointments, avoided discussing their challenges honestly, or disengaged from healthcare altogether.
Stigma also damaged relationships between people with T2D and healthcare professionals. Trust was weakened, communication became more difficult, and some individuals felt discouraged from asking questions or seeking support.
Why does this matter & what needs to change?
These findings show that T2D stigma in healthcare is common and can negatively affect both wellbeing and access to quality diabetes care.
People living with T2D said they want healthcare professionals to:
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- Listen without judgment
- Show empathy and understanding
- Recognise their efforts to manage diabetes
- Treat them as experts in their own lived experience
Participants also highlighted the need for greater education and awareness about T2D and diabetes stigma across healthcare systems.
What next?
The ACBRD is conducting further research to understand what stigma-free diabetes healthcare means to people living with T2D. The findings will help inform practical guidance for healthcare professionals on how to provide stigma-free diabetes healthcare.
People living with T2D around the world can sign up to the ACBRD newsletter to stay informed about future research opportunities and contribute to efforts to reduce diabetes stigma.
Healthcare professionals can also refer to Language Position Statements for practical guidance on talking with and about people with diabetes in ways that communicate CARE and avoid BIAS.
Take the Pledge to End Diabetes Stigma here.
Check out our past blogs for more research on diabetes stigma and language matters.
Reference:
Ekpor E, Manallack S, Garza M, Speight J, Holmes-Truscott E. Experiences of type 2 diabetes stigma in healthcare settings: a mixed-methods systematic review. Diabetes Res Clin Pract. 2026;236:113283.
