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

Objectives: Diabetes self-management often occurs in social contexts, around others without diabetes. International consensus identifies the pervasive presence of social stigma toward those with diabetes, negatively impacting health, well-being, and social and professional lives. In this study we aimed to identify the social experiences of Canadian adults living with type 1 diabetes (T1D) or type 2 diabetes (T2D).

Methods: An online survey was completed by 1,799 adults with diabetes (T1D: n=786; T2D: n=1,013). The survey assessed diabetes stigma, emotional well-being, diabetes distress, quality of life, and health-care 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% of respondents reported people making unfair assumptions about their capabilities, and 69% reported being judged for what they eat. For T2D, 41% reported being stigmatized as having a "lifestyle disease," and 31% reported being judged for their food choices. Being treated differently due to diabetes was common: 54% with T1D reported being rejected, and 22% with T2D reported being treated as sick. Many respondents 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 in way that will lead to greater respect, empathy, and support for all people living with diabetes in Canada.