Understanding and Addressing Diabetes Stigma via Human Rights and Grassroots Advocacy

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Aims and background: Diabetes mellitus exists in all countries, with rising incidence and prevalence of multiple forms, including type 2 diabetes (T2D), gestational diabetes, type 1 diabetes (T1D), and maturity-onset diabetes of the young.While substantial research attention has been aimed at diabetes prevention, education, and treatment, considerably less focus has been directed toward pervasive experiences of diabetes stigma and discrimination.Diabetes stigma has profound negative impacts on psychosocial wellbeing, healthcare engagement, self-management, and clinical outcomes.We aimed to review diabetes-related stigma and some approaches to reduce stigma.Materials and methods: An international, multidisciplinary group of authors, including clinicians, a human rights lawyer, and people with lived experience of diabetes, reviewed definitions, causes, and consequences of diabetes-related stigma, as well as approaches to reduce it.Particular focus was given to the role of international and domestic human rights law and to grassroots, community-led initiatives.Lived experience examples from several countries are included.Results: Diabetes-related stigma is common and is associated with adverse physical and mental health outcomes and increased discrimination across many areas of life.Even with the existence of protective human rights instruments and laws, people with diabetes (PWD) continue to experience discrimination in healthcare, education, employment, and community settings.Conclusion: Diabetes related stigma is widespread, harmful, and under-researched.Addressing this requires a globally united approach, yet tailored to local circumstances, involving PWD, their families and communities, healthcare systems, diabetes organizations, industry, media, policymakers, and governments.In all advocacy endeavors, genuine intent, language, and imagery matter.Clinical significance: Awareness of and addressing diabetes related stigma and discrimination is essential to improving the health and wellbeing of people with or at risk of diabetes and strengthening healthcare systems and communities.

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