Ending diabetes stigma: global evidence and a call to Action
Jane Speight, Elizabeth Holmes-Truscott, Matthew Garza, Renza Scibilia, Sabina Wagner, Asuka Kato, Victor Pedrero, Sonya Deschênes, Susan J. Guzman, Kevin L. Joiner, et al. (Giesje Nefs & Per Winterdijk of Diabeter)
Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. Lancet Diabetes Endocrinol. 2024 Jan;12(1):61-82.
People with diabetes frequently experience stigma and discrimination, including blame, negative stereotypes, and unfair treatment in healthcare, education, employment, and society at large. These experiences can harm emotional wellbeing, self-care, access to optimal healthcare, and social and professional opportunities. Despite growing research and advocacy efforts, diabetes stigma has historically received less attention than stigma related to other health conditions such as HIV, mental illness, or obesity. To accelerate progress, there is a need for international consensus on the evidence base and on concrete recommendations to challenge and eliminate diabetes stigma and discrimination.
An international, multidisciplinary expert panel of 51 members from 18 countries conducted 12 topic-focused rapid reviews and participated in a three-round Delphi process. The panel achieved consensus on 25 statements of evidence and 24 statements of recommendations, as well as unanimous agreement on a global pledge to end diabetes stigma and discrimination. The work integrates evidence across diabetes types, cultures, and settings, and is grounded in established stigma frameworks.
Key findings:
- Diabetes stigma is primarily driven by blame, fear, disgust, and oversimplified beliefs about personal responsibility for diabetes and its outcomes.
- On average, around four in five adults with diabetes experience stigma, and one in five experience discrimination, including in healthcare, education, and employment.
- Diabetes stigma is associated with worse psychological outcomes, including higher depressive symptoms, anxiety, diabetes distress, and lower self-esteem.
- Experiences of stigma are linked to poorer self-care, higher HbA1c, increased hypoglycaemia, delayed access to treatments and technologies, and disengagement from healthcare.
- Stigma is perpetuated through language, media representations, healthcare interactions, public health campaigns, and policy and legal frameworks.
- Evidence on effective stigma-reduction interventions remains limited, highlighting a major research gap.
The consensus statement makes clear that diabetes stigma and discrimination are harmful, unethical, and counterproductive to improving health outcomes. Ending stigma requires coordinated, long-term action across healthcare, research, education, media, policy, and advocacy, with meaningful involvement of people living with diabetes. The authors emphasise the need to replace narratives of blame with balanced, evidence-based understandings of diabetes that reflect biological, psychosocial, and societal factors.
Concluding, the authors state
"Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive, and collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination" -
Please click here for the Pubmed link.