Brits Living with Diabetes Feel Stigma and Bias Impact Their Ability to Manage Their Condition

• First UK-wide survey of people with and without diabetes to explore diabetes-related stigma identifies the general public’s unconscious bias towards those with the conditionⁱ
• Nearly 75% of Brits living with diabetes have viewed negative commentary towards their condition on social media, television and onlineⁱ
• One in four Brits with diabetes believe stigma has negatively impacted their management of the condition (24%), and emotional wellbeing (31%)ⁱ
• To address the key points raised in the survey, Abbott has launched a new campaign in the UK, Let’s Change Perspective, to provide tools to help create better conversations around diabetes

MAIDENHEAD, BERKSHIRE – TUESDAY 24 JANUARY 2023 – With diabetes prevalence expected to reach almost 5.5 million across the UK by 2030ⁱⁱ, new results from a first-of-its-kind survey by Abbott has identified a clear disconnect between the perceptions of the British public and those living with diabetes when it comes to stigma surrounding the condition.

The survey of 1,500 people shows the UK population has a good understanding of the impact of managing the condition, accurately associating diabetes with “insulin” (76%), and “testing sugar levels” (40%)ⁱ. However, 80% of the general public claim to have never witnessed diabetes stigma, despite almost the same proportion of the diabetes community (73%) having seen stigmatising behaviour towards the condition, particularly on social media, TV and onlineⁱ.

The disconnect between the stigma experienced by people with diabetes and the general public’s lack of awareness of it, suggests widespread unconscious bias towards those with diabetes, which can lead to negative effects on emotional wellbeing and health outcomes.^iii,ivRoughly one in four (24%) people with diabetes surveyed agree that others’ opinions have affected their ability to manage their conditionⁱ.

Stigma is created by a lack of knowledge and a fear of the unknown. When people see something they don’t understand or perceive as scary, they can react negatively. For people with diabetes this can play out in many ways such as food judgement, social or workplace exclusion, or inadvertently making hurtful comments. Something as simple as ‘should you be eating that?’ can lead to feelings of blame and judgement^ii,iii.

Professor Deborah Christie, consultant clinical psychologist and clinical lead for paediatric and adolescent psychological services at University College London Hospital’s NHS Foundation Trust said, "Abbott has uncovered important findings about the role that unconscious bias plays in diabetes stigma and the negative impact that this can have. Stigma experienced by people with diabetes is one of the largest barriers to them engaging with care and treatment. If you feel blamed or judged in any part of your life, then it can have a significant effect on your emotional wellbeing, and you will be less likely to engage with that area."

Abbott’s survey highlights further insights for those living with diabetes, including:

• More than one in five people (21%) with diabetes are left feeling self-conscious about their condition, with a third (31%) believing that the way the public speaks about diabetes also has a negative impact on their emotional wellbeingⁱ.
  • Almost everyone with diabetes surveyed, whether they have Type 1 or Type 2, believes people assume they are overweight (96%)ⁱ; and that their condition was caused by their lifestyle (64)% and lack of exercise (49%)ⁱ.
  • Almost four in five members of the public (78%) associate lack of exercise with Type 2 diabetesⁱ. While at surface level this may be accurate, as certain lifestyle factors are known to increase the risk of Type 2 diabetes, the causes for every person are different and complex^v.
  • Almost a third (29%) of the British public inaccurately believe that people with diabetes should only consume low sugar mealsⁱ, whilst 76% believe people with Type 2 diabetes should give up sugar altogetherⁱ. This misunderstanding regarding sugar consumption may fuel the unconscious bias behind the stigma and blame felt by those living with diabetes.

Abbott has launched a new campaign in the UK, Let’s Change Perspective to explore the impact of unconscious bias and to help change the conversation around diabetes. This includes a new tool, the Let’s Change Perspective Guide, developed in partnership with people with diabetes and Professor Christie, with input and guidance from Diabetes UK. The tool aims to empower everyone to challenge diabetes stigma in the moment in various situations such as in work, or hearing a joke or hurtful comment about diabetes. Allyship is key in helping to reduce stigma and improve the lives of people with diabetes.

Douglas Twenefour, Head of Care at Diabetes UK, said: “We welcome the Let’s Change Perspective campaign and guide as, together, they help demonstrate the importance of working collaboratively to address the stigma that affects people with diabetes. It’s incredibly important that people with diabetes are supported and empowered to live their lives and manage their condition as best they can, free from stigma.”

Professor Christie adds, "It is critical that the diabetes community and general public can come together with compassion and utilise tools, such as the Let’s Change Perspective Guide, to challenge bias and start to change the conversation."

Despite the public’s misconceptions of diabetes, the survey also found positive signals for improvement as the public recognise the impact of stigma, with approximately half (47%) agreeing that the language used to speak about diabetes reinforces stigmaⁱ and three quarters (75%) agreeing more education is needed to understand more about the conditionⁱ.

Neil Harris, general manager of Abbott's diabetes care business in the UK and Ireland, commented: "We want all people with diabetes to feel confident to care for themselves and to seek the right support for themselves and their condition. If we all took the time to understand diabetes a little better, and challenge the stereotypes that inadvertently cause harm, we can make a big difference to the lives of people living with this complex condition."

Through the Let’s Change Perspective campaign, Abbott will continue to work with the diabetes community to raise awareness of the impact of diabetes stigma and provide helpful solutions to reduce unconscious bias and support people with diabetes. __________________________________________________________________

Notes
Case studies available upon request.

The survey was commissioned by Abbott and conducted by Opinion Health in August 2022. The study had 1,500 participants from the UK, including 500 people with diabetes and 1,000 members of general public.

Let’s Change Perspective Guide was developed in partnership with people with diabetes and Professor Deborah Christie, with input and guidance from Diabetes UK. The guide looks at situations where stigma is frequently experienced and aims to arm people with diabetes, and importantly the general public, to challenge bias in the moment.

Tips from the guide include:

• Avoid comments that pass judgment on what someone is eating, or their weight
  • People with diabetes encounter a lot of unsolicited advice from “Are you really going to eat that?” to “If you try this diet/ lose weight, you’ll cure your diabetes”
  • It’s important to help those passing judgement to understand why it’s not appropriate and telling someone unsolicited how to manage their own condition can be hurtful.
• Think about the impact of words and opinions
  • It’s important to acknowledge if a person with diabetes points out that something said is disrespectful and to learn from that moment. Saying “It’s just a joke” may reinforce the hurt caused. Ask “How can I make this right?”
  • Being an ally for people with diabetes could take some of the burden away from more people with diabetes, as others speak up against inappropriate comments. Try saying “I wonder if you’ve considered the impact of your words. Diabetes is a serious and complex condition, and that comment wasn’t appropriate.”
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  References
  

  ⁱ Abbott Diabetes Care. Data on file. Survey among 1,500 participants in the UK, 2022.
  ⁱⁱDiabetes UK. 2021. 1-in-10 adults living with diabetes by 2030. 1-in-10 adults living with diabetes by 2030 | Diabetes UK Accessed Nov 2022
  ⁱⁱⁱValentine V. 2019. The most important thing we give to people is hope: Overcoming stigma in diabetes and obesity. ADA Outstanding educator in diabetes award lecture. 33 (1): 89–94.
  ^ivLiu NF. 2017. Stigma in people with Type 1 or Type 2 diabetes. Clinical Diabetes. 35 (1): 27–34
  ^vWu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014 Sep 6;11(11):1185-200. doi: 10.7150/ijms.10001. PMID: 25249787; PMCID: PMC4166864
  ^viData on file, Abbott Diabetes Care. Data based on the number of users worldwide for FreeStyle Libre family of personal sensor based glucose monitoring systems compared to the number of users for other leading personal CGM brands
  ^vii Data on file. Abbott Diabetes Care.
  ^viiiBased on a comparison of list prices of the FreeStyle Libre portfolio versus competitor CGM systems available worldwide. The actual cost to patients may or may not be lower than other CGM systems, depending on local reimbursement, if any.