End Diabetes Stigma and Discrimination
모든 유형의 당뇨인을 존중하겠습니다.
당뇨병에 대한 낙인이 존재하며 해로운 영향을 미친다는 것을 인식합니다．
당뇨병 (당뇨인)에 대한 나와 우리의 편견을 인정하고 이에 도전하겠습니다．
당뇨인과 소통하거나 그들에 대해 이야기할 때 정확하고 존중하며, 포용적이며, 비판적이지 않으며, 강점을 기반으로 언어, 메시지, 이미지를 사용하겠습니다.
두려움에 기반한 메시지와 이미지를 피하고 이에 도전하겠습니다.
당뇨병으로 인한 차별을 비판하며, 당뇨인에 대한 평등한 치료와 지원을 지지하겠습니다．
모든 당뇨인의 형평성을 증진하는 사업, 정책, 법안을 지지하겠습니다.
By Jo Chapman and Heather Verry
Background
Since 2015, Diabetes New Zealand has held Diabetes Action Month annually to raise awareness and educate the public. Each campaign amplifies the voices of people living with diabetes. In 2018, stigma became a key focus through the first Diabetes NZ Stigma Survey, exploring its impact across family, school, work, and social life.
Method
The 2018 campaign, Act Now To Live Well, highlighted the social cost of diabetes. Diabetes NZ partnered with the Australian Centre for Behavioural Research in Diabetes to adapt validated questionnaires and added demographic questions. The survey, distributed online via eDM, captured experiences from 824 respondents with type 1 and type 2 diabetes. Findings informed campaign messaging and future campaigns.
Outcomes
The stigma survey provided valuable insight into the emotional burden of diabetes, resonating with the community and media. Interest was high, as diabetes stigma had been little known until then. Key findings included:
The 2018 campaign generated 218 media items and reached over 300,000 individuals.
In 2020, Love Don’t Judge raised awareness of diabetes distress and its emotional and mental health impacts, reaching millions of New Zealanders through multiple platforms.
In 2024, Don’t Sugar Coat Diabetes, aimed to dispel myths, reduce stigma, and encourage Kiwis to understand and check their risk of type 2 diabetes.
Community involvement remains central, with people with lived experience sharing stories, appearing in videos, and engaging with media.
By Kamlesh Chitte
Background / Aim
For a rural girl in India, a Type 1 Diabetes (T1D) diagnosis is not only a medical condition — it becomes a lifelong social restriction. She is labelled “weak,” confined at home, removed from sports, protected from friendships, and quietly judged as “unfit” for marriage, work, or motherhood. Stigma shapes every decision others make about her body and her future.
This initiative aimed to confront this deeply gendered stigma and document the long-term impact of community-based support on rural girls’ education, mobility, identity, and life outcomes.
Methods
Across 25 years, over 1500+ rural girls with T1D participated in layered stigma-reduction activities within UDAAN’s peer-support environment, a safe space that allowed girls to be seen, heard, and believed.
Interventions targeted the exact points where stigma is enforced:
Role models, peer circles, and community sensitisation formed the emotional backbone of the program.
Outcomes
The initiative produced measurable shifts:
Lessons Learned
Gender-based stigma cannot be dismantled by information alone. It requires emotional safety, community solidarity, and lived-experience leadership. When rural girls receive long-term support as they did within UDAAN they rise beyond stigma and reshape cultural norms themselves.
Meaningful Involvement of Lived Experience:
Girls and young women living with T1D co-created peer activities, designed the messaging, led community sessions, and shaped the entire approach. Their experiences were not included they led the change.
Author(s) and affiliation(s)
Jeremy Auger – lived experience with type 1 diabetes
Anmol Budhiraja – lived experience with type 2 diabetes, loved, learned and laboured experience
Background / Aims(s)
This project is part of the Diabetes Action Canada Research-to-Action Fellowship in partnership with the Indigenous Diabetes Health Circle (IDHC). Community members described being misdiagnosed, having tests delayed and feeling dismissed in appointments—experiences that disproportionately affect Indigenous, Black and Brown people. Our aim is to create practical, culturally grounded tools that help people recognise symptoms, ask for essential tests and assert their rights in clinical settings.
Methods (Who, What, Where)
Together with IDHC, we held a co-design session with over two dozen Indigenous, Black and Brown participants who had lived or loved experience of diabetes or had supported family through misdiagnosis. Sharing Circles explored how racism, weight stigma and stereotypes about “who gets diabetes” shaped care and silenced questions.
Using participants’ words, we drafted “Diabetes Answers for Us” wallet cards listing common symptoms, key tests and plain-language rights for medical appointments. A short follow-up survey invites wider feedback and offers people the chance to review drafts before finalisation
Outcomes (achieved or expected)
The wallet cards and a companion easy-to-read guide will be freely available through Diabetes Action Canada and IDHC in early 2026. We expect them to provide discreet, portable support that increases confidence to ask for tests, helps people connect symptoms to diabetes and enables them to challenge biased or dismissive care in real time.
Lessons Learned (for scaling / adaptation)
Co-design confirmed that shame around diabetes and misdiagnosis is cultural and systemic, not personal. Low-barrier tools like wallet cards can interrupt that shame by giving people accessible language and questions. Grounding the tools in Indigenous, Black and Brown voices, plain language and low-tech design offers a model for adapting this work to other racialized and diaspora communities, including future versions for India.
Description of how people with lived experience are / have been meaningfully involved
The project is led by two Fellows whose lived, loved, learned and laboured experience spans type 1 diabetes, a new type 2 diagnosis, Indigenous identity, Indian diaspora identity, family caregiving and chronic-disease work. The co-design session with more than two dozen community members shaped every stage—from identifying systemic barriers and emotional triggers to deciding which rights, symptoms and tests to include. Their insights continue to guide the wording, visuals and evaluation of the final tools, ensuring they reflect real needs and restore agency in care.
By Chris Bright
Background / Aims(s)
Diabetes stigma negatively affects mental health, confidence, and participation in physical activity. The Diabetes Football Community (TDFC) was created to challenge these barriers by using football and futsal as vehicles for inclusion, education, and empowerment. Its aim is to normalise diabetes management in sport, reduce stigma, and foster peer support networks.
Methods (Who, What, Where)
Established in 2017, TDFC delivers grassroots football events, futsal tournaments, and educational projects across the UK and internationally. Activities include in-person training sessions, competitive fixtures, and digital engagement through social media, podcasts, and webinars. The community is open to people living with diabetes, their families, and supporters, creating safe spaces for shared learning and participation.
Outcomes (Achieved or Expected)
TDFC has reached thousands globally, with over 10,000 social media followers and hundreds attending events annually. Participants report improved confidence in managing diabetes during exercise, reduced feelings of isolation, and enhanced mental wellbeing. Educational content has supported healthcare professionals and coaches, increasing understanding of diabetes in sport and reducing misconceptions. TDFC’s advocacy has influenced policy discussions and inspired similar initiatives nationally and internationally.
Lessons Learned (Scaling or Adaptation)
Sport is a powerful tool for stigma reduction, but scaling requires strong partnerships with healthcare providers, sports governing bodies, and diabetes charities. Digital platforms have proven essential for global reach and sustainability, while co-design with community members ensures relevance and authenticity. Future adaptation will focus on expanding resource accessibility and integrating TDFC’s model into mainstream football structures.
By Mohammed Najeeb Ashraf
Background / Aims(s)
Diabetes technologies, such as insulin pumps and automated insulin delivery (AID) systems, ease care burdens, yet many users feel intimidated or judged as “not good enough” for these technologies. Here, we aim to reduce stigma around diabetes technology by creating an artificial intelligence (AI)-powered pump and AID chatbot navigator that offers an individualized space to ask sensitive questions, fostering confident shared decision-making with healthcare teams.
Methods
Through the Diabetes Action Canada Research-to-Action Fellowship program, two fellows with lived and loved experience of type 1 diabetes (T1D) led a co-design session with over two dozen people with diabetes and caregivers. Participants shared “heaviest” unasked questions from clinic or tech support groups, highlighting stigma from external and diabetes community sources that make technology feel inaccessible or unsafe. Session insights shaped the chatbot for four persona types (lived, loved, learned, and labored experience); using verified AID manufacturer guides and summaries; separating Canadian and United States (US)-specific information; offering grade 3‒5 reading level explanations; and avoiding recommendations, pricing, or medical advice.
Outcomes (achieved or expected)
Early user data informs rehearsing difficult questions about eligibility, safety, everyday use, and funding before clinic visits. A private space to explore “embarrassing” questions helps reduce shame and prepare technological options discussions with care teams. Expected outcomes include increased confidence in addressing diabetes technology-related questions, equitable access to geography-specific information, and identification of stigma-related themes to guide future education and advocacy efforts.
Lessons Learned (for scaling/adaptation)
Stigma extends beyond clinics into peer and tech support spaces. Participants described feeling judged for using or not using a particular system. Scaling requires ensuring anonymous, judgment-free tools for testing questions; relying on transparent, trusted information sources; separating country-specific content; and using simple, non-hierarchical devices or user comparisons. These elements adapt the tool to other regions and technologies while prioritizing stigma reduction.
By Yannick Temboh Alomba
Background / Aims(s)
The T1D Picnic addressed the psychosocial challenges faced by children and adolescents living with Type 1 Diabetes (T1D) in the Northwest Region of Cameroon, where late diagnosis, stigma, emotional distress, and caregiver burnout hinder effective disease management. The aim was to enhance emotional wellbeing, coping capacity, and social connectedness through a structured two-day psychosocial support picnic.
Methods
Implemented by RADA, the intervention brought together children with T1D and their caregivers in a therapeutic community setting. Activities included Cognitive Behavioral Therapy (CBT), sight-seeing, emotional support circles, peer discussions, art therapy, and experiential learning sessions. Pre- and post-test assessments using 5‑point Likert scales measured stress, anxiety, stigma, emotional regulation, coping, communication, burnout, and social wellbeing.
Outcomes
Children showed improved confidence and reduced disclosure challenges, with gradual strengthening of coping skills and quality of life. Caregivers demonstrated better communication, emotional support, and social wellbeing. Emotional shifts such as increased awareness of stigma among children and temporary emotional fatigue among caregivers were expected as part of early psychosocial adjustment.
Lessons Learned
Psychosocial support is essential for comprehensive diabetes management. Creating safe spaces for emotional expression reduces isolation and strengthens resilience. Early emotional turbulence is normal, highlighting the importance of continuous follow‑up. The model is scalable across similar low‑resource settings.
Involvement of People with Lived Experience
Children with T1D and their caregivers actively shaped discussions, identified priority challenges, co‑created coping strategies, and shared lived experiences. Their insights informed the design, delivery, and evaluation of the intervention, ensuring relevance and community ownership.
By Sana Ajmal
Background
Children and adolescents with Type 1 Diabetes (T1D) in Pakistan face a double burden: the daily challenges of managing their condition and the pervasive social stigma of being labeled “untouchable” or “abnormal.” Such experiences silently corrode self-belief, extinguish their spark, and push children into deep social isolation. Despite this burden, Pakistan has had no structured, community-based intervention directly addressing T1D-related stigma.
Objective
This study documents Pakistan’s first structured stigma-reduction initiative the Buddy System, led by Meethi Zindagi (MZ), combining peer support, culturally tailored diabetes education, and person-centered counselling. We aimed to understand the lived experiences of stigma among children with T1D and assess the early impact of MZ’s support approach.
Methods
Several in-depth case studies were conducted with children aged 8–17 who experienced school discrimination, friendship abandonment, family blame, and social withdrawal due to T1D. Narrative interviews with children and caregivers were complemented with field observations by MZ educators and researchers. Trained T1D peer leaders conducted home and community visits, intentionally bringing a small “gift of interest” (e.g., drawing book, football, storybook) to build trust, reduce fear of communication, and bridge the emotional gap between buddies and mentors. Thematic analysis examined stigma triggers, emotional consequences, and pathways of support.
Results
Narratives revealed recurrent themes of social shaming, fear of injecting insulin publicly, peer exclusion, and internalized stigma. MZ’s intervention offered safe emotional space, consistent mentoring, caregiver engagement, and accessible, culturally relevant education. Children reported increased confidence in self-management, re-engagement in school, and reduced fear of disclosure. Families noted improved acceptance and stronger coping capacity.
Conclusion
T1D-related stigma in Pakistan is a neglected barrier that deepens emotional distress and disrupts diabetes care. Engagement with trained mentors helped children remain connected, and many expressed the desire for follow-up visits every two months to stay motivated. All children in the program have since regained confidence and are now living more empowered, healthier lives. This model underscores the urgent need to integrate psychosocial and anti-stigma support into routine diabetes care.