BMJ Open. 2021 Dec 30;11(12):e055013. doi: 10.1136/bmjopen-2021-055013.
ABSTRACT
OBJECTIVES: To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes.
DESIGN: A secondary analysis of a cross-sectional study.
SETTING: Two university hospitals, one general hospital and one clinic in Tokyo, Japan.
PARTICIPANTS: Outpatients with type 2 diabetes aged 20-74 years and receiving treatment from diabetes specialist physicians (n=209) completed a self-administered questionnaire.
PRIMARY AND SECONDARY OUTCOME MEASURES: Self-stigma was measured as the primary outcome. Patient Activation Measure, body mass index and haemoglobin A1c were measured as secondary outcomes.
RESULTS: One-way analysis of covariance showed significant differences in self-stigma levels between the five groups of diabetes duration (≤5 years, 6-10 years, 11-15 years, 16-21 years and 22 years or more) after controlling for age, gender, education, marital status, diabetes treatment (insulin use) and diabetes-related complications, F(4,198)=2.83, p=0.026. Multiple comparisons using Bonferroni correction showed statistically significant differences in self-stigma levels between the groups with ≤5 years (95% CI 59.63 to 69.73) and 11-15 years with diabetes (95% CI 71.12 to 80.82; p=0.020). The highest mean level of self-stigma was observed in the group having diabetes for 11-15 years.
CONCLUSIONS: Self-stigma was associated with diabetes duration and was lowest after diagnosis and gradually increased, with its highest levels being observed in those having diabetes for 11-15 years. Self-stigma takes time to develop and gradually increases in individuals as it is learnt through direct experiences of diabetes-related stigma after self-administering treatment in everyday social situations.
PMID:35380981 | DOI:10.1136/bmjopen-2021-055013
