Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: A systematic review and meta-analysis
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Diabetes Research and Clinical Practice
Abstract
Aim: To synthesize quantitative research evidence on the association between type 2 diabetes (T2D) stigma and
psychological, behavioral, and clinical outcomes.
Methods: We searched APA PsycINFO, Cochrane Central, Scopus, Web of Science, Medline, CINAHL and EMBASE
through November 2022. Peer-reviewed observational studies examining the association between T2D stigma
and psychological, behavioral, and/or clinical outcomes were eligible for inclusion. Risk of bias was assessed
with the JBI critical appraisal checklist. Correlation coefficients were pooled in random effect meta-analyses.
Results: Our search produced 9642 citations, 29 met the inclusion criteria. Included articles were published
between 2014 and 2022. We found a weak positive correlation between T2D stigma and HbA1C (r = 0.16, 95%
CI:0.08 to 025, I
2 = 70%, N = 7 studies), a moderate positive correlation between T2D stigma and depressive
symptoms (r = 0.49, 95% CI: 0.44 to 0.54, I
2 = 26.9%, n = 5 studies) and diabetes distress (r = 0.54, 95% CI:
0.35 to 0.72, I
2 = 96.9%, n = 7studies). Persons with T2D stigma who experienced stigma tended to have less
engagement in diabetes self-management, though this association was weak (r = -0.17, 95% CI: − 0.25 to − 0.08,
I
2 = 79.8%, n = 7studies).
Conclusions: T2D stigma was associated with negative health outcomes. Further studies are required to disentangle the underlying causal mechanisms to inform the development of appropriate stigma-reduction
interventions.
Description
Research Article
Keywords
Stigma, Type 2 diabete, Diabetes stigma