Identification of Sociodemographic and Clinical Factors Influencing the Feeling of Stigmatization in People with Type 1 Diabetes

Abstract

Background: A large percentage of people with type 1 diabetes experience stigma, which may directly affect diabetes management. Moreover, it may adversely influence the acceptance of the disease and, thus, the treatment process, including compliance with medical and dietary recommendations. Therefore, it is important to seek adequate forms of counteracting the phenomenon of stigmatization. Thus, the aim of the study was to determine the factors influencing the level of perceived stigma by T1D patients, with particular emphasis on sociodemographic factors (including sex, place of residence, and education) and clinical factors related to the course of the disease. Methods: An observational cross-sectional online questionnaire was conducted in a group of 339 people with T1D. The link to the questionnaire was shared via social media. The DSAS-1 questionnaire translated into Polish was used as the research tool. Results: A moderate level of stigmatization was found (49.78 ± 14.54 points). It was significantly lower in people living in small towns compared to rural residents (ß = −0.121, p = 0.038), lower in people in relationships compared to those who are single (ß = −0.175, p = 0.001), in people diagnosed with T1D at an older age (ß = −0.107, p = 0.048), and in those who rated their financial situation as very good vs. bad (ß = −0.314, p < 0.001). It was also found that the level of stigma significantly decreased with age (ß = −0.181, p = 0.001). In addition, a significantly higher stigma perception was uncovered in the group of people with HbA1C > 7% than in the group ≤ 7% (ß = 0.118, p = 0.030). Conclusions: Due to the occurrence of stigma among people with T1D, which can directly affect the management of diabetes, effective and comprehensive efforts should be made to provide support to people with diabetes. It is also necessary to raise awareness among the general public and disseminate knowledge about diabetes, which can reduce stigmatization as a result. Anti-stigma messages should be included in the prevention programs about the potential side effects and risks associated with mistreating people with T1D.

Dietary guidelines in diabetes – why are they so difficult to follow?

“…Difficulties in complying with dietary recommendations are related to such issues as: • difficult glycemic control due to a variety of factors (physical activity, stress, hormonal changes, concomitant diseases); • the need to change eating habits, especially if the previous ones were inappropriate, eliminating or limiting the consumption of products such as sweets or processed foods; • failure to adapt the diet to the individual needs and preferences of the patient; • fatigue and routine associated with monitoring the diet and measuring blood glucose levels, lack of rapid improvement in glycemic control, which causes discouragement and weakens motivation; • lack of regular education and support from medical caregivers, dietitians and family in understanding the importance of specific nutritional principles; • failure to take account of the intellectual capacity to monitor carbohydrate intake, which is difficult and time-consuming, especially at the beginning; • resignation from following a diet and choosing unhealthy products in response to difficult emotions (stress, anxiety, frustration); • pressure in social situations, e.g., those related to meals in restaurants, during family or social gatherings, when people with diabetes feel pressure to eat what others eat [16][17][18].…”