Does Diabetes in the U.S come with a social stigma? (2016). [Digital image of pie charts displaying stigma rates.] Drug watch. Retrieved October 26, 2021 from https://www.drugwatch.com/featured/diabetes-stigma/.
Although Type 1 diabetes mellitus has been around for centuries, recently, it has been growing at epidemic proportions. The rise in diagnoses of T1D has led to the growth in the stigma around this chronic illness. Around 74% of children with T1D personally feel a stigma associated with their illness. This stigma not only negatively affects the mental and emotional health of these patients but also affects their ability to manage their physical needs with diabetes. Despite this stigma’s negative effects being so wide spread, there has been little attention related to understanding this stigma and finding ways to diminish its effects. A dual strategy of educating the public and providing resources to peer-support groups is fundamental to help improve the overall health of many T1D patients in North Carolina.
One major misconception that gives this stigma birth is that diabetes is self-inflicted and a result of an unhealthy lifestyle. However, science shows that T1D is not caused by dietary or other personal choices but takes place due to genetic mutations entirely out of one’s control. By publicly debunking this misconception it will shift this sense of blame felt by T1D patients to a feeling of empathy from others. Another route for this stigma to take place is through the management of diabetes. To manage T1D, one must continually check their blood sugar and inject themselves with insulin. These injections commonly lead to unwanted attention and embarrassment, which stem from a fear of people not understanding what these injections are for. Educating the public about what this management consists of can lead these patients to feel more accepted when having to regulate their blood sugar in public.
In North Carolina, this education can take place through government sanctioned events such as in school or government issued releases and social constructs such as protest or social marketing. Along with diminishing this stigma from the public, peer-support groups are needed to improve the health of students battling T1D. Peer support groups are needed as safe places for students to collaborate with youth who face the same obstacles. Raising funds and resources is vital for support groups to function and display to individuals that they are not alone in their disease.
Any step in combating this stigma will improve the overall health of patients all of over the state and lead North Carolina to being a safe place for individuals to be themselves.
Explication of Research:
Although Type 1 diabetes mellitus (T1D) has been around for centuries, recently, it has been growing at epidemic proportions (Schabert et al., 2013, p. 1). The CDC’s National Diabetes Statistics Report estimates by 2050, five million people in the United States are expected to be diagnosed with T1D (CDC, 2020, p. 6). This growth of T1D is also prevalent here in North Carolina as the prevalence rate is estimated to be 11.7 (Rogers et al., 2018, p. 3). This rise in diagnosed children with T1D has also led to the growth in the stigma around this chronic illness. Around 74% of children with Type 1 diabetes personally feel a stigma against them associated with their illness. This stigma roots from the lack of public knowledge around diabetes in general and its different types. Abdoli in his article “A discussion paper on stigmatizing features of diabetes,” confirms that is this stigma by compiling eighteen studies to observe how the public views diabetes. The common phrases that Abdoli found associated with diabetes are “sick,” “self-inflicting,” “contagiousness,” “requiring a dietary modification” and “drunk or drug abuser” (Abdoli et al., 2018, p.114). The negative connotation around diabetes has been shown to not only negatively affect the mental and emotional health of these patients but also it affects their ability to manage their physical care when dealing with their diabetes- all of which generally leads to negative health outcomes. Despite this stigma’s negative effects being so widespread, there has been little attention and resources related to understating this stigma and coming up with ways to diminish its effects on people living with diabetes. This stigma must be uprooted at its core through educating the public. While educating the public is a viable method, to fully combat this problem there must also be programs that walk alongside these patients and support them from within. This dual strategy of educating the public and providing resources to peer-support groups is fundamental to help improve the overall health of many T1D patients in North Carolina.
The common misconceptions behind Type 1 diabetes are what gives this stigma birth. One major misconception is that diabetes is self-inflicted and a result of an unhealthy lifestyle (Schabert et al., 2013, p. 2). This popular belief is quickly refuted by science as T1D is not caused by dietary or other personal choices but takes place entirely out of one’s control. It is caused by an autoimmune reaction that destroys cells in the pancreas that produce insulin (Uchigata, 2018, p. 209). By the spread of this knowledge, instead of blaming these patients for something that is outside of their control there might be added empathy towards them. This empathy is needed to help the patients with their mental health.
Another route for this stigma to take place is through the management of diabetes. To manage type 1 diabetes, one must continually check their blood sugar as well as inject themselves with insulin, which, thus far, can only be achieved by the use of a needle or an insulin pump. These injections and other forms of management commonly lead to unwanted attention and embarrassment, which stem from a fear of people not understanding what these injections or pumps are for (Uchigata, 2018, p. 210). This embarrassment leads patients to delay and even omit the injections that are essential to their health. In Brazeau a professor at the school of Human Nutrition at McGill University finds that students who felt a stigma towards their diabetes had a much higher rate of poor glycemic conditions opposed to those students who reported they felt no stigma towards their diabetes (Brazeau et al., 2018, p. 2). Educating the public on the management of diabetes will help patients feel more comfort in managing their diabetes. They will no longer have to hide their disease and can do whatever is best without fear of others judging them for it. This will in turn lead to healthier patients both mentally and physically.
In North Carolina, this education can take place through government sanctioned events such as in school or government issued releases as well as social constructs such as protest and social marketing. By teaching not only about diabetes itself but also the stigma behind it we can provide awareness to children at a young age. This is needed because it is easier to address social problems at a young age before the fallacy gets rooted too deep in their mind. The North Carolina Government can also get involved by promoting this knowledge through a government sponsored popular health video. Videos that provide scientific backing will help combat this stigma by relaying to the public this valuable information. The community in North Carolina also has a large part to play in lessening the effects of diabetes. They can promote this education by organizing protest to raise awareness to this problem. Lastly, one of the most effective ways to eliminate this stigma is by social marketing. By identifying this stigma, individuals can promote it to their communities and spread the word of its harm.
Along with diminishing this stigma from the public, peer-support groups for students are also needed to improve the health of patients diagnosed with T1D. In spite of facing this stigma kids are less likely to seek help when dealing with their diabetes. This too leads to the feeling of isolation, which is unhealthy mentally, emotionally, and physically. Peer support groups are needed as a safe place for students to seek assistance in overcoming the challenges of their diabetes. This can be different than confiding in family, peers or other adults because in these peer support groups youth are collaborating with people their age who face similar obstacles. A study preformed at various universities found a direct correlation that the students who participated in these clubs had much higher self-reported mental and physical health score than those who did not. These tests included levels of isolation, depressive symptoms and anxiety as well as stability in their glucose levels related to their diabetes (Saylor et al., 2018, p. 340). Peer-support groups can help with all of one’s challenges when facing diabetes. These groups are also an efficient to get rid of the feeling that these students are alone in their disease.
In North Carolina there are a limited amount of these peer support groups available for students who need them. Making these peer support groups more widely spread will benefit all T1D patients. There is a need for resources to enable more of these groups to take place. These resources can include funding to start these groups but also education to directly empower the individuals who start and run these groups. This could be done through workshops or conferences here in North Carolina that enable these leaders. The increase of these peer led groups are a vital step in creating a healthier life for these individuals.
This stigma causes added stress to an illness that is already stressful enough. There is no reason why someone should feel casted out or looked down upon for something they have no control over. This problem must be fixed in sake of the people who face these disparities on a daily basis. Any step in combating this stigma will greatly improve the overall health of T1D patients all over the state. Moving in this direction will also make North Carolina more equip to handle health injustices of all kinds.
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Brazeau A., Nakhla M., Wright M., Henderson M., Panagiotopoulos C., Pacaud D., Kearns P., Rahme E., Da Costa D., Dasgupta K., (2018). Stigma and its association with glycemic control and hypoglycemia in adolescents and young adults with Type 1 Diabetes: Cross-sectional study. Journal of Medical Internet Research, 20(4). https://www.jmir.org/2018/4/e151/[CDC] Center for Disease Control and Prevention, (2020). National Diabetes Statistics Report 2020: Estimates of Diabetes and Its Burden in the United States. Center for Disease Control and Prevention, 1-30. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
Rogers M., Catherine K., Banerjee T., Lee J., (2017). Fluctuations in the incidence of type 1 diabetes in the United States from 2001 to 2015: a longitudinal study. BCM Medicine, 15(199), 1-9. https://doi.org/10.1186/s12916-017-0958-6
Rogers M., Rogers B., Basu T., (2018). Prevalence of Type 1 Diabetes Among People Aged 19 and Younger in the United States. Preventing Chronic Disease, 15, 1-5. https://www.cdc.gov/pcd/issues/2018/pdf/18_0323.pdf
Saylor J., Lee S., Ness M., Ambrosino J., Ike E., Ziegler., Roth C., Calamaro C., (2018). Positive health benefits of peer support and connections for college students with type 1 Diabetes Mellitus. The Diabetes Educator, 44(4), 340-347. https://doi.org/10.1177/0145721718765947
Schabert, J., Browne, J.L., Mosely, K. Speight. (2013). Social Stigma in Diabetes. Patient 6, 1–10. https://doi.org/10.1007/s40271-012-0001-0
Uchigata, Y. (2018). The still persistent stigma around diabetes: Is there something we can do to make it disappear. Diabetology International, 9, 209-211. https://doi.org/10.1007/s13340-018-0373-z
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