Stigma associated with early-onset type 2 diabetes: A secondary qualitative analysis

与早发性2型糖尿病相关的污名:一项二次定性分析

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Abstract

OBJECTIVES: Diabetes-related stigma has been previously investigated in people with type 1 diabetes and older people with type 2 diabetes. However, stigma in early-onset type 2 diabetes (EOT2D) remains understudied, despite increasing prevalence and the unique characteristics of this population. Hence, this study aimed to explore perceptions and experiences of stigma in people living with EOT2D, from the perspectives of people living with EOT2D and HCPs who have work in EOT2D care. DESIGN: Secondary qualitative analysis of semi-structured interviews. METHODS: Semi-structured interviews were conducted with 25 young adults with EOT2D and 25 HCPs. Data were analysed using inductive reflexive thematic analysis and subsequently presented using a framework for understanding diabetes-related stigma. RESULTS: Findings highlight causes, experiences, and consequences of stigma in EOT2D, in addition to potential mitigating strategies. The media, healthcare professionals and others perpetuate stigma, underpinned by misconceptions that type 2 diabetes is self-inflicted, and attitudes of blame. PEOT2D experience judgement and harmful stereotypes, including 'fat', 'unhealthy', 'lazy', and type 2 diabetes being an 'old-person's disease'. Psychological consequences of stigma were reported, including self-blame, embarrassment, and shame, leading to behavioural consequences of non-disclosure and reluctance to seek help. Education, raising awareness, and non-judgemental communication were highlighted as strategies to minimize stigma and its consequences. CONCLUSIONS: Stigma is highly pervasive in the lives of young adults living with EOT2D and can cause harmful consequences. Given the increased risk of physiological and psychological complications in this population, efforts to reduce stigma in EOT2D should be prioritized.

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