Evidence map›Paper›PMID 40483539›Full record

ArticleDiabetic medicine : a journal of the British Diabetic Association2025

Experiences of diabetes stigma among adults with type 1 and type 2 diabetes: A multi-study, multi-country, secondary analysis.

Elizabeth Holmes-Truscott, Eloise Litterbach, Uffe Søholm, Paul A Agius, Hamzah Alzubaidi, Valery Bodziony, Joncarl Bresolin, Kim Fletcher, Matthew Garza, Kevin L Joiner and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. From language matters to stigma-free communication in diabetes: Evolution, challenges, and next steps.Diabetic medicine : a journal of the British Diabetic Association · 2026
    Review
  5. Type 1 diabetes stigma: A UK survey of adults living with type 1 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2026
    Observational
  6. Article
  7. Examining the Relationship Between Weight Stigma, Diabetes Stigma, and HbA1c in Adults with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Elizabeth Holmes-TruscottSchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.ORCID https://orcid.org/0000-0001-9139-4663
Eloise LitterbachSchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.ORCID https://orcid.org/0000-0002-4618-1068
Uffe SøholmSchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Paul A AgiusFaculty of Health, Deakin University, Burwood, Victoria, Australia.
Hamzah AlzubaidiPharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.ORCID https://orcid.org/0000-0001-5122-271X
Valery BodzionySt Elizabeth Physicians, Crestview Hills, Kentucky, USA.
Joncarl BresolinDiabetes Canada, Toronto, Ontario, Canada.
Kim FletcherDiabetes Canada, Toronto, Ontario, Canada.
Matthew GarzaThe diaTribe Foundation, San Francisco, California, USA.
Kevin L JoinerSchool of Nursing, University of Michigan, Ann Arbor, Michigan, USA.
Rebecca M PuhlDepartment of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA.
Michio ShimabukuroDepartment of Diabetes, Endocrinology, and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Laura SyronDiabetes Canada, Toronto, Ontario, Canada.
Hiroko TakaikeDivision of Diabetology and Metabolism, Department of Internal Medicine, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Michael VallisFamily Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.ORCID https://orcid.org/0000-0002-0165-5936
Heather VerryDiabetes New Zealand, Wellington, New Zealand.
Jennifer A HallidaySchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Sarah L ManallackSchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.ORCID https://orcid.org/0009-0001-5292-2897
Timothy C SkinnerSchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Jane SpeightSchool of Psychology, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.ORCID https://orcid.org/0000-0002-1204-6896

Funding

Diabetes Canada
6 · The paper itself

Abstract

aimsTo conduct a multi-study, cross-country examination of diabetes stigma among adults with type 1 and type 2 diabetes (T1D, T2D).

methodsPre-existing, cross-sectional studies of adults (aged ≥18) completing the T1D or T2D Diabetes Stigma Assessment Scales (DSAS-1/DSAS-2) were collated. Descriptive statistics were calculated for (sub)scale and item scores. Variance-components linear random-effect multi-level modelling (nested random intercepts for country and study) estimated overall mean (sub)scale scores, 95% confidence intervals, intraclass correlation coefficients (ICC) and 95% prediction intervals. Likelihood ratio (LR) tests provided inference for country- and study-specific heterogeneity.

resultsEleven studies were included from six countries (Australia k = 2, Canada k = 1, Japan k = 2, New Zealand k = 1, UAE k = 1, USA k = 4) in four languages (Arabic k = 1, English k = 7, Japanese k = 2, Spanish k = 1). Six studies included n = 3114 adults with T1D (insulin pump: 42%; 75% aged <60 years). Ten studies included n = 6586 adults with T2D (insulin-treated: 37%; 44% aged <60 years). Most reported ≥1 experience of diabetes stigma (T1D = 91%; study range: 84%-96%; T2D = 77%; 69%-89%). In 10 studies, the 'blame and judgment' subscale was most endorsed (T1D = 83%; 62%-89%, T2D = 70%; 53%-79%). Most adults with T1D reported 'identity concerns' (73%; 62%-80%), and 47% of adults with T2D reported 'self-stigma' (30-60%). Being 'treated differently' was least common (T1D = 46%; 40%-54%, T2D = 37%; 28%-47%). Low levels of heterogeneity were observed in mean [SE] total scores (DSAS-1: 54 [0.94] ICC = 0.02, p < 0.001; DSAS-2: 44 [1.1], ICC ≤0.4, p < 0.001).

conclusionsFindings suggest a high and relatively consistent prevalence of diabetes stigma across studies and within and across countries, supporting calls for local and global action.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2Social StigmaAdultAustraliaCanadaCross-Sectional StudiesFemaleHumansJapanMaleMiddle AgedNew ZealandUnited Statesdiabetesdiabetes stigmapsychologypsychosocialquestionnaire

Identifiers

PMID40483539
PMCPMC12257424

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.