Eitel Kelsey B, Pihoker Catherine, Barrett Catherine E, Roberts Alissa J
Department of Pediatrics, University of Washington, Seattle, WA 98105, USA.
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
J Endocr Soc. 2024 Aug 5;8(9):bvae136. doi: 10.1210/jendso/bvae136. eCollection 2024 Jul 26.
Diabetes stigma is the social burden of living with diabetes. People with diabetes may experience or perceive an adverse social judgment, prejudice, or stereotype about living with diabetes at work, school, in healthcare settings, popular culture, or relationships. This review describes the methods that have been used to assess diabetes stigma, and explores the prevalence of diabetes stigma, associated sociodemographic and socioeconomic factors, cultural factors, and how diabetes stigma is associated with clinical outcomes, including HbA1c levels, diabetic ketoacidosis, severe hypoglycemia, and chronic complications, in addition to psychosocial complications in youth, adolescents, and adults with type 1 diabetes (T1D) and type 2 diabetes (T2D). The prevalence of diabetes stigma has been reported as high as 78% in adults with T1D, 70% in adults with T2D, 98% in youth and adolescents with T1D, and is unknown in youth and adolescents with T2D. Diabetes stigma has been associated with lower psychosocial functioning, decreased self-care behaviors, higher HbA1c levels, and higher frequency of diabetes complications in adults with T1D and T2D. In adolescents and young adults with T1D, diabetes stigma is associated with lower psychosocial functioning, higher HbA1c levels, and higher frequency of diabetic ketoacidosis and severe hypoglycemia episodes in addition to chronic complications. In youth and adolescents with T2D, one study demonstrated an association of diabetes stigma with lower psychosocial functioning, higher HbA1c levels, and presence of retinopathy. Gaps exist in our understanding of the mechanisms of diabetes stigma, particularly in youth and adolescents with T2D.
糖尿病污名是糖尿病患者所面临的社会负担。糖尿病患者在工作场所、学校、医疗环境、大众文化或人际关系中，可能会经历或感受到关于患糖尿病的负面社会评判、偏见或刻板印象。本综述描述了用于评估糖尿病污名的方法，并探讨了糖尿病污名的患病率、相关的社会人口学和社会经济因素、文化因素，以及糖尿病污名如何与临床结局相关联，这些临床结局包括糖化血红蛋白（HbA1c）水平、糖尿病酮症酸中毒、严重低血糖和慢性并发症，此外还包括1型糖尿病（T1D）和2型糖尿病（T2D）的青年、青少年及成年人的心理社会并发症。据报道，T1D成年患者中糖尿病污名的患病率高达78%，T2D成年患者中为70%，T1D青年及青少年中为98%，而T2D青年及青少年中的患病率尚不清楚。糖尿病污名与T1D和T2D成年患者较低的心理社会功能、自我护理行为减少、较高的HbA1c水平以及较高的糖尿病并发症发生率相关。在T1D的青少年及年轻成年人中，糖尿病污名除了与慢性并发症相关外，还与较低的心理社会功能、较高的HbA1c水平以及较高的糖尿病酮症酸中毒和严重低血糖发作频率相关。在T2D的青年及青少年中，一项研究表明糖尿病污名与较低的心理社会功能、较高的HbA1c水平以及视网膜病变的存在有关。我们对糖尿病污名机制的理解存在差距，尤其是在T2D的青年及青少年中。
