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Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations

Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations
Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations

People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination.

2213-8587
61-82
Speight, Jane
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Speight, Jane
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Subramanian, Mythily
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Terkildsen Maindal, Helle
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Valentine, Virginia
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Vallis, Michael
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Skinner, Timothy C.
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Speight, Jane, Holmes-Truscott, Elizabeth, Garza, Matthew, Scibilia, Renza, Wagner, Sabina, Kato, Asuka, Pedrero, Victor, Deschênes, Sonya, Guzman, Susan J., Joiner, Kevin L., Willaing, Ingrid, Babbott, Katie M., Cleal, Bryan, Dickinson, Jane K., Halliday, Jennifer A., Morrissey, Eimear C., Nefs, Giesje, O'Donnell, Shane, Serlachius, Anna, Winterdijk, Per, Alzubaidi, Hamzah, Arifin, Bustanul, Cambron-Kopco, Liz, Santa Ana (Cornejo), Corinna, Davidsen, Emma, de Groot, Mary, de Wit, Maartje, Deroze, Phylissa, Haack, Stephanie, Holt, Richard I.G., Jensen, Walther, Khunti, Kamlesh, Kragelund Nielsen, Karoline, Lathia, Tejal, Lee, Christopher J., McNulty, Bridget, Naranjo, Diana, Pearl, Rebecca L., Prinjha, Suman, Puhl, Rebecca M., Sabidi, Anita, Selvan, Chitra, Sethi, Jazz, Seyam, Mohammed, Sturt, Jackie, Subramanian, Mythily, Terkildsen Maindal, Helle, Valentine, Virginia, Vallis, Michael and Skinner, Timothy C. (2024) Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations. The Lancet Diabetes & Endocrinology, 12 (1), 61-82. (doi:10.1016/S2213-8587(23)00347-9).

Record type: Review

Abstract

People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination.

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20231109 IntConsensDiabStigma Manuscript_R3_Clean_Unlinked - Accepted Manuscript
Restricted to Repository staff only until 19 June 2024.
Available under License Creative Commons Attribution Non-commercial No Derivatives.
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Accepted/In Press date: 9 November 2023
e-pub ahead of print date: 19 December 2023
Published date: January 2024
Additional Information: Funding Information: We thank Bernard Yeboah-Asiamah Asare (Deakin University, Geelong, VIC, Australia) for providing independent coordination of the Delphi surveys, enabling panel members’ responses to remain confidential; he designed, formatted, and distributed the online survey under the supervision of EH-T and JSp; analysed the results, providing deidentified results for reporting purposes; and communicating in confidence with panel members (eg, providing their individual ratings for review in subsequent surveys). We thank Robert Brines (Bite Medical Consulting, Cambridge, UK; supported by The diaTribe Foundation) for his administrative assistance collating the draft sections of the methods and evidence summary, authored by the expert panel, into a single document, formatting, and compiling references. We thank Victoria Yutronich (Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia) for developing the community-based EndDiabetesStigma.org website, enabling individuals and organisations across the world to view and take the pledge online. We acknowledge and thank all the individuals and organisations that have taken the pledge to end diabetes stigma. We acknowledge and thank all those who have enabled translations into languages other than English, which are available via the EndDiabetesStigma.org/pledge-translations/. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. Publisher Copyright: © 2024 Elsevier Ltd

Identifiers

Local EPrints ID: 484419
URI: http://eprints.soton.ac.uk/id/eprint/484419
DOI: doi:10.1016/S2213-8587(23)00347-9
ISSN: 2213-8587
PURE UUID: 8cf07990-6616-427c-b6ca-9580ae1dc113
ORCID for Richard I.G. Holt: ORCID iD orcid.org/0000-0001-8911-6744

Catalogue record

Date deposited: 16 Nov 2023 11:55
Last modified: 25 Apr 2024 04:01

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Contributors

Author: Jane Speight
Author: Elizabeth Holmes-Truscott
Author: Matthew Garza
Author: Renza Scibilia
Author: Sabina Wagner
Author: Asuka Kato
Author: Victor Pedrero
Author: Sonya Deschênes
Author: Susan J. Guzman
Author: Kevin L. Joiner
Author: Ingrid Willaing
Author: Katie M. Babbott
Author: Bryan Cleal
Author: Jane K. Dickinson
Author: Jennifer A. Halliday
Author: Eimear C. Morrissey
Author: Giesje Nefs
Author: Shane O'Donnell
Author: Anna Serlachius
Author: Per Winterdijk
Author: Hamzah Alzubaidi
Author: Bustanul Arifin
Author: Liz Cambron-Kopco
Author: Corinna Santa Ana (Cornejo)
Author: Emma Davidsen
Author: Mary de Groot
Author: Maartje de Wit
Author: Phylissa Deroze
Author: Stephanie Haack
Author: Richard I.G. Holt ORCID iD
Author: Walther Jensen
Author: Kamlesh Khunti
Author: Karoline Kragelund Nielsen
Author: Tejal Lathia
Author: Christopher J. Lee
Author: Bridget McNulty
Author: Diana Naranjo
Author: Rebecca L. Pearl
Author: Suman Prinjha
Author: Rebecca M. Puhl
Author: Anita Sabidi
Author: Chitra Selvan
Author: Jazz Sethi
Author: Mohammed Seyam
Author: Jackie Sturt
Author: Mythily Subramanian
Author: Helle Terkildsen Maindal
Author: Virginia Valentine
Author: Michael Vallis
Author: Timothy C. Skinner

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