A Square Peg in A Round Hole: Social Experiences of Living with Diabetes in Canada in 2024.

Abstract

Introduction: Diabetes self-management often occurs in social contexts, around others without diabetes. International consensus identifies the pervasive presence of social stigma towards those with diabetes, negatively impacting health, well-being, social and professional lives. We aimed to determine the social experiences of Canadian adults living with type 1(T2D) or type 2 (T2D) diabetes.

Methods: An online survey was completed by 1,799 adults with diabetes (T1D=786, T2D =1013). The survey assessed diabetes stigma, emotional well-being , diabetes distress , quality of life and healthcare experiences . Analyses involved descriptives of stigma experiences and associations with other measures.

Results: Experiencing blame and judgment for having diabetes was common. For T1D, 73% report people making unfair assumptions about their capabilities, and 69% report being judged for what they eat. For T2D, 41% report being stigmatised as having a 'lifestyle disease', and 31% report being judged for their food choices. Being treated differently due to diabetes was common: 54% with T1D report being rejected; 22% with T2D report being treated as sick. Many with T1D were concerned about managing diabetes in public (44.2%) and many with T2D were embarrassed about having diabetes (27.4%). Greater stigmatization was associated with lower general emotional well-being, greater diabetes distress, and greater negative impact on quality of life.

Conclusions: Adults with T1D or T2D commonly experience stigmatization, negatively impacting well-being and quality of life. These data support changing the conversation about diabetes, to provide greater respect, empathy and support for all people living with diabetes in Canada.