We have compiled the resource library to connect you with information, organizations, and tools that can help you understand diabetes stigma and join in the growing movement to eliminate shame and blame.


Words do more than reflect reality – they create reality

Join the growing movement to change the conversation about diabetes

People with diabetes, their families, and people at risk of diabetes, deserve communications that are clear and accurate, respectful, inclusive, and free from judgment and bias.

We can choose to have a culture in which people feel valued, understood, and supported — or one in which people feel misunderstood, undermined, stigmatized, and excluded.

This Language Guide makes it easy!
We've consolidated guidance from leading diabetes organizations and researchers into an easy-to-use #LanguageMatters guide for anyone who communicates about diabetes.
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Concern about diabetes stigma is rooted in science and our expanding knowledge of its potentially harmful effects on health

Foundational studies document that stigma is real

Researchers have begun to sketch the outlines of diabetes stigma but more studies are needed to fully document the scope and breadth of the problem in the US. Here are key research findings and a proposed path for future research. Click the plus sign next to each study to learn more.

Social stigma in diabetes: a framework to understand a growing problem for an increasing epidemic (Schabert et al., 2013)

Takeaways: Social stigma is a concern for people with diabetes and is experienced in many domains of their life. A new framework can help people better understand diabetes stigma in terms of:

  • Causes: attitudes of blame, feelings of fear and disgust, a felt need to enforce social norms and avoid disease
  • Experiences: being judged, rejected, and discriminated against
  • Consequences: distress, poor psychological well-being, sub-optimal self-care

Strategies to address stigma include education, protest, counseling, and social support.

Access article here.

“I call it the blame and shame disease”: a qualitative study about perceptions of social stigma surrounding type 2 diabetes (Browne et al., 2013)

Takeaways: Interviews with people with type 2 diabetes showed that they believe their condition is stigmatized and many have experienced stigma directly. These interviews highlighted themes related to:

  • Experiences: blame, negative stereotyping, and discrimination
  • Sources: media, healthcare professionals, friends, family, and colleagues
  • Consequences: hiding their diagnosis and psychological stress

The researchers believe more studies should be conducted to identify ways to measure and address stigma.

Access article here.

Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care (Puhl et al., 2020)

Takeaways: Weight stigma (internal and external), as well as diabetes self-stigma, can lead to a number of concerning outcomes including:

  • Higher diabetes distress
  • Less diabetes self management
  • Lower self-efficacy
  • Lower quality interactions with healthcare professionals

Access article here.

The Use of Language in Diabetes Care and Education (Dickinson et al., 2017)

Takeaways: Language affects people’s perceptions of and behaviors toward people with diabetes. Experts recommend using language that is:

  • Neutral, non-judgmental, and based on facts, actions, or physiology/biology
  • Free from stigma
  • Strengths-based, respectful, inclusive, and hopeful
  • Fosters collaboration between patients and providers
  • Person-centered

Access article here.

‘I'm not a druggie, I'm just a diabetic’: a qualitative study of stigma from the perspective of adults with type 1 diabetes (Browne et al., 2014)

Takeaways: Interviews with people with type 1 diabetes showed that they believe their condition is stigmatized and that this may result from their association with people with type 2 diabetes. These interviews highlighted themes related to:

  • How stigma is characterized: blame, negative social judgment, exclusion, and discrimination
  • Sources: media, healthcare professionals, friends, family, and school teachers
  • Consequences: impacts relationships, social identity, self-management of their diabetes, and emotional well-being, and leads people to hide their diagnosis

The researchers believe more studies should be conducted to identify ways to address stigma. They also acknowledge that adults with type 1 sometimes cause stigma for people with type 2 diabetes.

Access article here.

Our language matters: Improving communication with and about people with diabetes. A position statement by Diabetes Australia (Speight et al., 2021)

Takeaways: The way people communicate can influence, persuade, and affect the way people view the world, and the current language used for and about diabetes has serious problems. Experts recommend:

  • Make small changes: it’s easy and makes a big difference
  • Change the conversation by starting with the language you use, calling out harmful language in others, and remembering that words have power
  • Choose words that:
    • show CARE (curious, accurate, respectful, and empathetic)
    • remove BIAS (blame, irreverence, authority, stigma)
  • Focus on more than just words: body language, tone, and attitude

Access article here.

The stigma associated with gestational diabetes mellitus: A scoping review (Davidsen et. al., 2022)

Takeaways: This scoping review of the literature showed that women with gestational diabetes report stigma (both externally as overt discrimination or internally as guilt and blame), which may affect both their mental and physical health. Trends in the data highlight that when women with gestational diabetes do experience stigma, it can lead to:

  • Avoiding screening
  • Not following dietary recommendations
  • Not reporting blood glucose readings
  • Social isolation
  • Poor mental well-being

Access article here.

Foundational studies on weight stigma
Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review (Wu et al., 2018)

Takeaways: A systematic review resulted in 33 studies highlighting that weight stigma was associated with negative physiological and psychological outcomes, including, but not limited to:

  • Obesity
  • Diabetes risk
  • Eating disturbances
  • Depression
  • Anxiety

Access article here.

The Stigma of Obesity: A Review and Update (Puhl et al., 2009)

Takeaways: This systematic review expands upon previous findings of weight bias in major domains of living, documents new areas where weight bias has been studied, and highlights ongoing research questions that need to be addressed to advance this field of study.

Access article here.

A Meta-Analysis of Weight Stigma and Health Behaviors (Zhu et al., 2022)

Takeaways: A meta-analysis of 54 studies including over 40,000 participants from 11 countries showed that weight stigma is positively related to unhealthy behaviors and negatively related to healthy behaviors. This was consistent regardless of stigma type, the focus of the health behavior, and the sample characteristics.

Access article here.

Joint international consensus statement for ending stigma of obesity

Takeaways: People with obesity experience pervasive, harmful social stigma that results in physical and psychological harm, worse health care, and discrimination in social settings. A multidisciplinary group of international experts, including representatives of scientific organizations, reviewed the available evidence on the causes and harms of weight stigma and developed a joint consensus statement with recommendations to eliminate weight bias and encourage a new public narrative about obesity that is more in line with modern scientific knowledge.

Access article here.

Studies on stigma from healthcare professionals
A Qualitative Study of Perceived Responsibility and Self-Blame in Type 2 Diabetes: Reflections of Physicians and Patients (Beverly et al., 2012)

Takeaways: Interviews with 19 endocrinologists and primary care providers and 34 people with type 2 diabetes highlighted both of these groups views on peoples’ difficulty in achieving their diabetes treatment goals:

  • Healthcare professionals assumed responsibility for their patients’ inability to reach their treatment goals, they speculated their patients may feel guilt, frustration, or disappointment as a result of not reaching goals, and they felt many people did not fully understand the consequences of diabetes.
  • People with diabetes blamed themselves for not being able to carry out treatment recommendations and for their lack of progress. Some speculated their healthcare professionals might feel disappointed in or frustrated by them.

Access article here.

Reducing the Stigma of Diabetes in Medical Education: A Contact-Based Educational Approach (Beverly et al., 2019)

Takeaways: Researchers evaluated the impact of a contact-based education patient panel in an Endocrine and Metabolism course on second-year medical students’ diabetes attitudes and diabetes stigma. Though a third of the medical students showed signs of stigma toward people with diabetes prior to the panel, the one-time, contact-based intervention improved students’ attitudes toward diabetes, including an increase in empathy and a better understanding of the disease.

Access article here.

Overcoming Weight Bias in the Management of Patients With Diabetes and Obesity (Puhl et al., 2016)

Takeaways: Weight bias from healthcare professionals can lead to lower quality of care for people with obesity and diabetes which is of particular concern given the increased emphasis on body weight and obesity in diagnosing and treating people with diabetes. This may be mitigated by interventions aimed at supporting and empowering people with obesity and diabetes such as:

  • Improved training and education around the complex causes of obesity
  • Encouraging the use of respectful language when discussing body weight
  • Concerted challenges to negative weight-based stereotypes in the clinical settings

Access article here.

Additional research will help refine our understanding and direct efforts for change

Our research workgroup is developing an agenda for future research that will help document the extent and impact of the blame and shame that people with diabetes experience.

Topics of interest for study include:

  • Observational study to assess the prevalence of diabetes stigma/self-stigma in media
  • Survey (using validated measures) of people with diabetes (type 1 and type 2) to assess the mental and physical health impact of diabetes stigma/ self-stigma
  • Survey of healthcare professionals to assess bias toward people with diabetes
  • Survey of the general public to assess bias toward people with diabetes
  • Intervention testing as informed by the three survey studies