Stigma Basics

It’s time we stop blaming and shaming people who live with diabetes. Diabetes is a complex and serious condition that no one asks for.

Stigma is shame.
Stigma is judgment.

Stigma refers to the experiences of exclusion, rejection, prejudice, blame, and discrimination that people unfairly experience based on a characteristic or perceived difference. It can be external, coming from other people and society, or it can be internal, meaning an attitude you hold about yourself.

Diabetes stigma stems from the idea that poor choices and unhealthy behaviors cause diabetes. This belief oversimplifies a complex biological condition and overlooks key factors such as genetics or a person’s environment and socioeconomic context. As a result, people with diabetes experience misplaced judgment and blame. (Yan, 2021)

What does stigma look like?

In 2021, as part of National Diabetes Week, Diabetes Australia launched the Heads Up on Diabetes and Stigma Campaign which included videos that highlight the ways people with diabetes may experience stigma.

You can also read and listen to the poem, “Take it in,” by Josh Kuntzman which paints a unique and compelling portrait of the emotions and challenges of a chronic condition – and of being unfairly blamed and judged.

Stigma contributes to negative diabetes health outcomes

Well-meaning people sometimes act as though blame and criticism will motivate people with diabetes to engage more actively in their health. In fact, an abundance of evidence shows that stigma can worsen health outcomes (Schabert et al., 2013).

People with diabetes report feelings of fear, embarrassment, blame, guilt, anxiety, and low self-esteem as a result of experiencing stigma. These negative emotions can result in depression and higher levels of stress, which drive unhealthy behaviors and increase the risk of developing health complications.

Blame and judgment may also result in worse self-care and diabetes management.

For example, people with diabetes have reported injecting insulin only in public restrooms or at home, making unhealthy food choices to avoid declining what is offered, and manipulating glucose logs to avoid criticism from significant others or healthcare professionals.

Stigma may also inhibit people from seeking necessary care, particularly when the source of the stigma is healthcare professionals. (Yan, 2021)

For people and populations who may be at risk for diabetes, stigma can also act as a barrier to awareness and prevention. Stigma makes people with diabetes fear being exposed or labeled as disabled, and discourages them from being open about their diagnosis.

What are six things I should know about diabetes stigma?

  1. Diabetes stigma exists everywhere including in family, school, social, workplace, and healthcare settings.
  2. People with different types of diabetes may experience different forms of stigma.
  3. Stigma is prevalent even within the diabetes community.
  4. Stigma is directly connected to how we talk about people with diabetes.
  5. People may not realize they’ve experienced stigma.
  6. Diabetes stigma can be accompanied by other forms of bias and discrimination related to race, class, disability, gender, or other conditions.

How does stigma affect people with diabetes?

Type 1

Report that stigma has impacted their emotional life – feeling shame, blame, isolation, & guilt.

Feel as though others believe diabetes is a character flaw or a failure in personal responsibility.

Report that stigma has impacted their social life.

Report that stigma has impacted their diabetes management.

Type 2

Feel as though others believe diabetes is a character flaw or a failure in personal responsibility.

Report that stigma has impacted their emotional life – feeling shame, blame, isolation, & guilt.

Report that stigma has impacted their social life.

Report that stigma has impacted their diabetes management.

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diabetes stigma