Stigma and healthcare professional support among adults with diabetes in Japan: A cross-sectional study

Diabetes-related stigma poses challenges for individuals with diabetes, including impaired self-care. Understanding its relationship with healthcare professional support is essential to clarify strategies for reducing stigma. This study aimed to examine the association between diabetes stigma and the support provided by physicians and nurses.

A cross-sectional survey was conducted from October 2022 to May 2023 in Osaka, Japan, among outpatients attending hospitals and clinics with diabetes specialists. Participants were aged ≥18 years with type 1 or type 2 diabetes; those with gestational diabetes or unable to complete the questionnaire were excluded. Diabetes-related stigma was assessed using the Kanden Institute Stigma Scale, whereas support from physicians and nurses was evaluated using the doctors' and nurses' support scale. Data were analyzed using multivariate logistic regression. Ethical approval was obtained prior to study initiation.

Diabetes-related stigma was inversely associated with physicians' support and nurse's support. Social and self-stigma were associated with physicians and nurses' support among participants aged <65 years but not among those ≥65 years. By contrast, discordant stigma was associated with physicians' support in the younger group and with both physicians' and nurses' support-particularly in health information subscales-among older participants.

Support from physicians and nurses may reduce diabetes-related stigma. Younger adults may benefit from advocacy and personalized care, whereas older adults require enhanced emotional and informational support. Healthcare professionals should address stigma to improve self-management and quality of life among people with diabetes.