Diabetes stigma and language use among medical students: A cross-sectional survey study

Stigmatizing language in diabetes is well-documented among practicing health care professionals, but less well known about medical students. This study examined the use of stigmatizing language among medical students to identify opportunities for early intervention.

We conducted a descriptive, exploratory cross-sectional survey study to examine medical students' use of and perceptions of diabetes-related language and diabetes stigma. We summarized language use and perceptions using descriptive statistics. To examine differences by year in medical school and intended career path, we conducted Kruskal-Wallis H tests with Dunn's post hoc comparisons. Spearman's rank correlations were used to assess associations among language use, perceptions and diabetes stigma.

Among the 245 respondents (mean age = 25.0 ± 2.4 years, 65% women, 71% White), nearly all (96%) reported using at least one non-recommended term, with 61% using six or more terms frequently. The five most common used terms included 'test', 'diabetic', 'blood sugar', 'control' and 'obese'. The five most negatively rated terms were 'unmotivated', 'fail', 'failure', 'noncompliant' and 'nonadherent'. Language use and perceptions varied by year in medical school and intended career path; however, the differences did not follow a specific pattern. Spearman's rank correlations showed respondents who reported more frequent use of non-recommended terms also perceived them more positively. Furthermore, respondents who expressed more negative attitudes towards diabetes were more likely to use non-recommended language.

Stigmatizing language and negative attitudes towards diabetes were common among medical students. Future research should evaluate whether educational interventions produce sustained improvements in diabetes language use and attitudes toward diabetes among medical students over time.