Abstract
Background: Stigma of chronic disease has become an area of focus in recent years and there is increasing evidence that stigmatisation has a negative impact on the lives of those suffering from Type 1 Diabetes (T1D). Stigma has been correlated with poor blood glucose control, emotional distress, isolation, and an increased risk of complications and disability. There has been extensive research on stigmatisation of people with Type 2 Diabetes (T2D) but little has been done on T1D. With the increasing prevalence of T1D worldwide, health professionals need to incorporate strategies to reduce stigma, educate others, and support people with T1D who are experiencing or have experienced stigma to reduce the negative impact on their daily lives.
Aim: To explore the impacts of stigma on the lives of people with T1D and the implications for health professionals. Inclusion and exclusion criteria: Peer-reviewed studies between 2009 and 2019 were included if there was a diagnosis of T1D, participants were over 13 years of age, or completed by parents if they were under 13 years of age, published in the English language, a peer reviewed article, and were related to the research aim.
Method: An integrative review was used to collate data from qualitative, quantitative and mixed methods studies. CINAHL, Ovid Medline, Psych Info and Scopus databases were searched using specific terms for peer-reviewed articles, which were then filtered using the inclusion/exclusion criteria and quality appraised using JBI assessment tools.
Findings: Sixteen articles were included in this review (Qualitative n=12; Quantitative n=2; Mixed methods n=2). The primary studies were conducted over 10 countries and a range of ethnicities. Narrative analysis revealed three overlying syntheses and the following seven categories: Emotional impact; Impact on self-management; Type 1 versus type 2; Stigma in the workplace; Impact on social life; Strategies to reduce stigmatisation; Improving wellbeing.
Conclusion: People with T1D experience stigmatisation, impacting all areas of their life. It induces negative emotions, impacts their social and work life, and reduces the ability to self-manage effectively. Sources of stigma include indistinction between T1D and T2D and a lack of education around what a diagnosis of T1D means, and how it can be managed. Educating the public and reducing stigmatisation through the media, as well as supporting people with T1D who have experienced stigma, is important.
Implications: Health professionals must educate others on both T1D and T2D due to the misinformation about diabetes as a whole in an effort to reduce stigmatisation. Health professionals must also increase support for people with T1D who have experienced or are experiencing stigmatisation.