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

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

LANCET DIABETES & ENDOCRINOLOGY(2024)

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摘要
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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