Diabetes Stigma and Patient Self-Management

Stigma associated with diabetes arises from societal misconceptions that portray the condition as a consequence of personal failings, leading to feelings of shame, blame and social exclusion. This stigma can be experienced externally—through discrimination by healthcare professionals, employers or peers—or internally, as self-stigma in which individuals internalise negative beliefs. Such experiences undermine patient self-management, eroding confidence and adherence to essential behaviours such as glucose monitoring, dietary regulation, medication adherence and engagement with healthcare services. A growing body of research highlights the reciprocal relationship between stigma and self-management: stigmatising attitudes exacerbate psychological distress and diabetes distress, while poor self-management can reinforce negative stereotypes. Addressing diabetes stigma therefore carries global significance, not least by improving clinical outcomes and reducing healthcare costs. Interventions that target public perceptions, encourage supportive language, enhance resilience and empower patients have demonstrated promise in reducing stigma and fostering more effective self-management strategies across diverse cultural settings.

Research from Nature Portfolio

Recent studies have examined the philosophical and social underpinnings of the term ‘patient’ and its role in diabetes care. Analysis of language use reveals that framing individuals solely as ‘patients’ reinforces power imbalances within the biomedical model, which can contribute to stigmatisation by defining people by their illness. Campaigns that advocate for person-centred language challenge this discourse, emphasising that respectful terminology can foster more equitable interactions, improve therapeutic relationships and support self-management by acknowledging individual agency and lived experience.

Diabetes Stigma and Patient Self-Management publication trend

The graph below shows the total number of articles in diabetes stigma and patient self-management across all publications each year (not limited to Nature Index journals).

Technical terms

Stigma: A social process of devaluation that arises when a condition is perceived as shameful, leading to discrimination or prejudice.

Self-management: The daily tasks undertaken by individuals to control symptoms, adhere to treatment regimens and maintain quality of life in chronic illness.

Self-stigma: Internalised negative beliefs and feelings about oneself resulting from the perception of being stigmatised.

Diabetes distress: Emotional distress specifically related to the burden of living with and managing diabetes.

Empowerment: The process by which individuals gain confidence, skills and autonomy to participate actively in decisions about their own care.

References

1. Exploration of the social and philosophical underpinning of ‘the patient’—what this means for people with a long-term condition. Humanities and Social Sciences Communications (2024).
2. Predictors of stigma perception by people with type 1 diabetes: A cross-sectional analysis of the BETTER registry. Diabetes & Metabolic Syndrome Clinical Research & Reviews (2024).
3. The relationship between psychological resilience and quality of life among the Chinese diabetes patients: the mediating role of stigma and the moderating role of empowerment. BMC Public Health (2023).
4. The relationship between stigma and psychological distress among people with diabetes: a meta-analysis. BMC Psychology (2023).