How To Overcome Shame and Stigma With Type 2 Diabetes

On paper, Type 2 diabetes is a medical condition. In reality, this diagnosis often comes with extra baggage, including shame and blame.

Diabetes specialist Shannon Knapp, BSN, RN, CDCES, shares how stigma can shape life with diabetes, and how you can rise above the noise.

Why Type 2 diabetes shame is a common feeling

Public stigma that Type 2 diabetes (T2D) is solely a self-inflicted condition is everywhere. And the more that noise is repeated, the more it can seem like a fact. “It’s easy to take that messaging personally and internalize it,” Knapp understands.

This phenomenon is called self-stigma. You may have thoughts like “I did this to myself” or “I deserve this.” (You didn’t, and you don’t.)

The combination of public stigma and self-stigma can lead to overwhelming shame. Studies show that people with T2D commonly feel judged, monitored and perceived as a burden.

How T2D stigma started

Type 2 diabetes is a condition with complex causes. But due to its link to obesity, society often reduces T2D to a simple — albeit wrong — explanation: It happens because of a lack of self-control. (To be clear, this isn’t the cause of obesity either.)

“Most of the stigma around Type 2 diabetes comes from the misunderstanding that it’s purely a lifestyle disease,” says Knapp. “But that’s not true. Several factors can lead to it. While obesity and physical inactivity are modifiable risk factors for Type 2 diabetes, there are lots of other risk factors that you can’t change, like genetics, age, race and ethnicity.”

But the stigma is widespread. You may hear diabetes digs and see finger-wags from many sources. This can range from TV shows and social media posts to coworkers, family members and even healthcare providers.

“It’s so pervasive. I mean, it really is everywhere,” she continues. “People, including providers, may not realize they’re using harmful language. But people with diabetes still experience the effects of it.”

Why it’s a problem

The mental health impacts of stigma and shame may be obvious. Being constantly ridiculed can lower your self-esteem. It can lead to depression and anxiety, too.

But the physical health effects may be less apparent. Because of diabetes stigma, you may be more likely to:

• Avoid medical appointments
• Not ask for help or support from loved ones
• Not take enough, or any, medication
• Be resistant to using insulin — even if your body needs it

All these behaviors can result in a lack of proper Type 2 diabetes management. This can have long-term impacts. “Over time, consistently high blood sugar may lead to complications, like nerve and organ damage,” Knapp states.

How to overcome Type 2 diabetes stigma and shame

So, what can you do? You may not be able to avoid misconceptions from the outside world. But you can change the way you think about diabetes. In turn, that can shape — and improve — how you physically care for yourself. Knapp shares three ways to do this.

1. Join a support group

Thriving with Type 2 diabetes takes a village. It’s helpful to have both medical professionals and loved ones on your side. But another big potential support is the diabetes community.

Consider connecting with others living with T2D through support groups. They may be in-person or online. “Support groups are a great way to relate and feel less alone,” Knapp explains. “It helps to know that others are facing the same challenges you are — and overcoming them.”

2. Change your language

Words matter. Many common phrases related to diabetes hold moral judgment. Adjusting these phrases can help change the way you think. And then, you may view diabetes less negatively.

For example, try these word swaps:

• Manage instead of control: It’s impossible to have complete control of diabetes. But you can manage it with habit changes and/or medication.
• In-range or out-of-range blood sugar instead of good or bad: Blood sugar levels aren’t a moral reflection of who you are as a person. They’re changing data points. Try to use language that treats them as such.
• Checking your blood sugar instead of testing it: A test implies that you can pass or fail it. Instead, you’re just checking in on your current level.

It may take time to get used to these changes. But before long, they’ll become second nature. Encourage your loved ones to get on board with this lingo, too.

Unfortunately, you may still hear negative language, even in healthcare settings.

“Words like ‘noncompliant’ have been standard use in the medical field for a long time,” Knapp shares. “I think we in healthcare have a responsibility to consider the language we use, to consider how we approach Type 2 diabetes. Change is slow, but more providers are understanding the impact of what they say.”

3. Educate others

Stigma comes from misunderstanding. “Many people just don’t know about the complexity of Type 2 diabetes,” Knapp says. That’s where education can help.

If you have questions about the condition, read about it from trusted online sources. You can also ask your healthcare provider questions.

Once you have a solid understanding, you can start educating your closest loved ones. Explain the risk factors for Type 2 diabetes and how the condition affects your life. Share ways they can help you.

Eventually, you may be more open about talking about diabetes with coworkers and acquaintances. If you hear a T2D misconception, try to speak up with facts. And encourage your support system to have your back.

Moving forward

It may take a while to change public opinion. But you can control — er, manage — how you think about Type 2 diabetes. Making peace with this condition can help you take steps to better care for yourself — both physically and mentally.