Stigma in Type 2 Diabetes: A Study from Southern India

Abstract

“Diabetes stigma” refers to a psychological disturbance in an individual who is diagnosed with diabetes. This condition has been studied primarily in subjects with type 1 diabetes whereas research on the stigma associated with type 2 diabetes is scarce, particularly in India. Against this backdrop, the present study focuses on understanding demographic variations in the experience of diabetes stigma. It also examines the association between diabetes stigma and physical activity, stressors as well as the length of diagnosis. This study further explores the predictors of stigma among demographic variables, diabetes duration and life style variables (physical exercise and stressors). 333 subjects with type 2 diabetes mellitus presenting to a tertiary care diabetes and endocrine centre in southern India were recruited (196 men, 137 women age range 25 - 78 years). They were evaluated using the Diabetes Stigma Assessment Scale-2 (DSAS-2) to assess diabetes stigma, along with structured interviews that collected demographic, clinical and lifestyle related information. ANOVA and t-test results showed that the tested demographic variables (age, gender, occupation, level of education and income), clinical and life style variables (diabetes duration, number of stressors and exercise) had significant influence on the experience of diabetes stigma. When these associations were tested using two separate multiple regression models, only age was found to be a significant predictor of stigma in terms of the total stigma experience and its subdomains namely the perception of being treated differently by others, self-stigma and blame and judgment by others. Interestingly, participants’ gender did not differentiate significantly in their experience of stigma. Similarly, all the three tested clinical and life style variables emerged as significant predictors of various domains of diabetes stigma. Diabetes stigma is closely linked with age and clinical features, life style factors such as duration of diabetes, number of stressors being experienced and physical exercise.