Community News
March 28, 2018 By Krista Banasiuk
Stigma should not be part of a diabetes diagnosis

The first thing my mom does when she wakes every morning is test her blood sugar. From there, her day is full of activities intended to ensure she stays healthy: she follows a strict dietary regimen, she exercises, she tests her blood sugar, and takes medication. She also checks her calendar regularly to ensure visits to her doctor are scheduled to have her feet and eyes examined.

My mom lives with type 2 diabetes (T2D) and does all this in hopes of avoiding the physical complications of the disease, such as vision loss, foot or leg amputation, nerve damage, and heart disease. But there’s one complication that she can do little to avoid -- the mental health toll of stigma. 

Because of its connection with diet and exercise, people with T2D face a “blame-the-victim” mentality: they are wrongfully accused of having brought their condition on themselves due to poor lifestyle choices. They are shamed and blamed for their disease, leaving many feeling embarrassed and guilty.       

In many ways, these stigmatizing beliefs represent warped versions of the truth -- the links between T2D and eating habits, physical activity levels and weight do exist. However, they are not as straightforward as common knowledge would have us believe.

While some people with obesity do have diabetes, many more do not. Many people who exercise regularly, eat nutritious food and are otherwise health conscious, develop T2D, despite their healthy habits. In fact, there is a strong genetic component to the disease. A family history of T2D greatly increases one’s chance of developing it.  

What’s more, social, economic, and environmental factors can make healthy living difficult, impacting both the development of T2D and the challenges associated with managing it. For example, it's more difficult to afford healthy food on a low or fixed income. Also, low-income neighbourhoods often do not offer opportunities for inexpensive exercise -- sidewalks may not be well maintained, there may be no bike lanes, public transit or walking trails. For those consistently worried about paying the bills or working extra hours, finding time to exercise, or the money to pay to join organized sports or other exercise programs, is not a high priority.

While we do not wish to ignore individual risk factors, framing unhealthy behaviours as “choices” is unfair: it does not account for the structural conditions outside of an individual’s control that contribute equally, if not more, to one’s lifestyle.

So why the stigma? News reports related to T2D are often voiced over videos of overweight individuals sauntering about, ice cream in hand. This draws a connection between weight, diet and diabetes, and strengthens the myth that those living with diabetes brought it on themselves.

Armed with inaccurate information, family and friends may assume their loved ones living with diabetes lack willpower and may accuse them of eating too much sugar or police their eating habits. 

Even health-care professionals are not immune to reinforcing stigmatizing beliefs. Doctors may unconsciously bring their own biases into the room when dealing with patients with T2D, especially if those patients are also living with overweight or obesity – highly stigmatized conditions in their own right. This may make it difficult for doctors to empathize with or support patients properly.

Such negative beliefs and attitudes about T2D have real consequences for the emotional and physical health of those living with diabetes. Many prefer to hide their disease and report feeling embarrassed and ashamed, which likely contributes to their higher-than-average rates of depression and anxiety.

To address this stigma, media must stop perpetuating harmful stereotypes and work alongside professional groups to provide accurate information about the many causes and effects of T2D. Health-care providers should be offered training to support a psychosocial approach and ensure patients are treated with compassion. My mom would certainly appreciate these changes. Let's work together to end diabetes stigma, and ensure that people like my mom and the many others living with type 2 diabetes can live healthful, happy lives.

Krista Banasiuk (pictured above, left, with her mom) is the manager of research and public policy at Diabetes Canada.

Have you ever been blamed for your diabetes? Tell us.

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