Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: A systematic review and meta-analysis

Akyirem, Samuel; Ekpor, Emmanuel; Namumbejja Abwoye, Diana; Batten, Janene; Nelson, LaRon E.

doi:10.1016/j.diabres.2023.110774

Cited by 20 publications

(12 citation statements)

References 47 publications

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“…1 Extant literature on diabetes stigma is limited but has highlighted perceived and experienced stigma in type 1 2 and type 2 diabetes. 3 Research in other health conditions has found that stigma reduces engagement with treatment and chances of recovery, is associated with psychological burden and fuels health and social inequalities. 4 There is therefore a need to better understand the multifactorial impact of stigma on people living with diabetes in order to reduce its impact, 5 and this has become a strategic priority for Diabetes UK.…”

Section: Stigma Experiences Of Adults Living With Diabetes: Results F...mentioning

confidence: 99%

Stigma experiences of adults living with diabetes: Results from a Diabetes UK survey

McKechnie,

Broomhead,

Scior

et al. 2024

Diabet Med

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Section: Stigma Experiences Of Adults Living With Diabetes: Results F...mentioning

confidence: 99%

Stigma experiences of adults living with diabetes: Results from a Diabetes UK survey

McKechnie,

Broomhead,

Scior

et al. 2024

Diabet Med

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“…A review of the relationship between type 2 diabetes and stigma revealed that stigma was associated with adverse health outcomes, including negative impacts on glycaemia and engagement in self-management behaviours. 11 To the knowledge of the authors, only one review has been published regarding the effects of stigma on type 1 diabetes. 12 This review focused on the experience of individuals living with type 1 diabetes as well as their caregivers and found that stigma negatively impacted sociocultural factors such as discrimination at work, finding a partner, and overall quality of life.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of stigma on the management of type 1 diabetes: A systematic review

Embick,

Jackson,

Stewart

2024

Diabet Med

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AimsTo systematically review the literature investigating the links between stigma and the management of type 1 diabetes.MethodsA systematic literature review was conducted in accordance with PRISMA guidelines. Both quantitative and qualitative data were considered. Included papers were subject to quality assessment using the Mixed Methods Appraisal Tool (MMAT), and a narrative synthesis of results was reported.ResultsNineteen articles met the inclusion criteria and were included in the final analysis. Amongst these, one study used mixed methods, nine were qualitative, and nine were quantitative. All studies found a negative relationship between stigma and type 1 diabetes management. Qualitative studies provided a further understanding of the effects observed in the quantitative studies and found that stigma can affect self‐care activities, disclosure of diabetes, and the uptake of diabetes technology. Systemic causes of stigma and intersectional stigma were also observed.ConclusionsThis review highlights that people with type 1 diabetes are negatively affected by stigma, irrespective of their age, gender, culture, or use of diabetes technology. Quantitative studies were limited, in that all studies were cross‐sectional, and there was a lack of standardisation across outcome measures. There is a need for interventions to target stigma on both an individual and a systemic level, particularly where people experience multiple intersecting stigmas.

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“…1 Persons with T2D may experience diabetes-related stigma (often manifesting as being unfairly treated by others, shamed or blamed for the disease) that is associated with negative health outcomes including diabetes distress, depressive symptoms, anxiety, poor glycaemic control and low engagement in beneficial self-management behaviours. 2 Persons with T2D are disproportionately impacted by obesity (body mass index [BMI] ≥ 30 kg/m 2 ), 3 which exposes them to additional stigma-related stressors based on their weight. While there is substantial stigma surrounding T2D, 2 weight-related discrimination is much more pervasive because weight status is highly visible and less likely to be concealed.…”

Section: Introductionmentioning

confidence: 99%

“…2 Persons with T2D are disproportionately impacted by obesity (body mass index [BMI] ≥ 30 kg/m 2 ), 3 which exposes them to additional stigma-related stressors based on their weight. While there is substantial stigma surrounding T2D, 2 weight-related discrimination is much more pervasive because weight status is highly visible and less likely to be concealed. 4 Weight-related discrimination includes overt negative attitudes, stereotypes, misconceptions and unfair treatments that overweight or obese individuals may experience.…”

Section: Introductionmentioning

confidence: 99%

Weight‐related discrimination, perceived stress and psychological and physical well‐being of persons with type 2 diabetes: A mediation analysis

Akyirem,

Ekpor,

Abwoye

et al. 2024

Diabet Med

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AimsThe aim of the study was to examine perceived stress as a mediator of the association between weight‐related discrimination and physical and psychological well‐being among persons with type 2 diabetes (T2D).MethodsData were obtained from 5104 persons with self‐reported T2D participating in the All of Us research programme in the United States. The Everyday Discrimination Scale, Cohen's Perceived Stress Scale (PSS) and PROMIS Global Health Scale were used to measure weight‐related discrimination, perceived stress and health outcomes (physical and psychological), respectively. Mediation effects of PSS were tested by bootstrapping with 5000 random samples.ResultsParticipants were, on average, 63.62 (SD 11.38) years old. Majority of them were female (55.53%), non‐Hispanic White (72.61%), married or living with a partner (56.92%), had a household income of <$35,000 (31.99%) and had some college education (33.54%). We found that approximately 18% of study participants reported having experienced weight‐related discrimination. We also found that weight‐related discrimination was independently associated with poor physical and psychological well‐being. These associations were partially mediated by perceived stress such that weight‐related discrimination was associated with greater perceived stress, which was in turn associated with poorer physical and psychological well‐being.ConclusionsGiven that weight‐related discrimination is associated with poor outcomes through elevated stress, interventions that target stress may disrupt this pathway thereby helping to reduce the health impact of weight‐related discrimination. This assertion should, however, be tested in future studies.

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Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: A systematic review and meta-analysis

Cited by 20 publications

References 47 publications

Stigma experiences of adults living with diabetes: Results from a Diabetes UK survey

Stigma experiences of adults living with diabetes: Results from a Diabetes UK survey

The impact of stigma on the management of type 1 diabetes: A systematic review

Weight‐related discrimination, perceived stress and psychological and physical well‐being of persons with type 2 diabetes: A mediation analysis

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