Diabetes Stigma: Understanding the Social Realities of Living with Diabetes in Canada
- t2diabetesnetwork
- Jul 21
- 7 min read
Key Highlights
✅ Stigma is common, 92% of people with T1D and 68% with T2D report experiencing it
✅ Blame, judgment, and exclusion are major forms of diabetes stigma
✅ Stigma affects emotional well-being, self-worth, and quality of life
✅ People with T2D often face stereotypes that it's a “lifestyle disease”
✅ Healthcare providers can play a key role in reducing stigma through empathy and support
Living with diabetes extends beyond just managing blood sugar; it involves navigating a world often fraught with misunderstanding, blame, and judgment. This often-invisible burden, known as diabetes stigma, significantly impacts the daily lives and well-being of those affected.
A recent groundbreaking study, titled "A Square Peg in a Round Hole: Social Experiences of Living With Diabetes in Canada in 2024," sheds critical light on this pervasive issue, revealing that 92% of Canadians with Type 1 diabetes and 68.2% of those with Type 2 diabetes report experiencing some form of stigma. This comprehensive research highlights the urgent need to address the social and emotional realities faced by millions.
The following CTV News video, "Breaking the stigma around diabetes," provides a personal perspective as it further explores this issue, featuring the "Above the Bias" campaign by Abbott and insights from individuals living with diabetes and healthcare professionals.
A National Snapshot: How the Study Was Conducted
In one of the most comprehensive examinations to date (published March 10, 2025), researchers from Dalhousie University, Diabetes Canada, Deakin University, and The Australian Centre for Behavioural Research in Diabetes collaborated to shed light on the lived experiences of Canadians with Type 1 and Type 2 diabetes. Their study, A Square Peg in a Round Hole: Social Experiences of Living With Diabetes in Canada in 2024, uncovers a troubling truth: stigma is a daily burden for most people with diabetes.
Now let's take a closer look at what the study revealed, and why it matters more than ever. To truly understand what life with diabetes looks like across Canada, the researchers designed a nationwide survey that reached far and wide.
Their goal? To capture the experiences of adults living with either Type 1 or Type 2 diabetes, in a way that reflected the diversity of people and places across the country.
They began by working with Environics, a national market research company, which led the initial recruitment through its online panel. To broaden their reach, they also partnered with Diabetes Canada and dQ&A, a platform that amplifies the voices of people with Type 1 diabetes, to invite participants through email. To be eligible, individuals had to be 18 or older and have a confirmed diagnosis of Type 1 or Type 2 diabetes. To make sure all regions of the country were fairly represented, they used regional quotas during recruitment.
In total, 1,799 adults completed the survey:
786 people (43.7%) were living with Type 1 diabetes (T1D)
1,013 people (56.3%) were living with Type 2 diabetes (T2D)
Participants completed a detailed survey that included several validated tools designed to explore a wide range of experiences, from emotional health and stigma to healthcare quality and daily life with diabetes.
Some of the key assessments included:
The Diabetes Stigma Assessment Scales (DSAS-1 for T1D and DSAS-2 for T2D), which measured feelings of blame, judgment, and stigma, both from others and internalized.
The WHO-5 Well-Being Index, a five-question scale that captured emotional well-being.
The PAID-5, which focused on emotional distress related to diabetes.
The DAWN2 Impact of Diabetes Profile, which assessed how diabetes affects daily life.
And the PACIC, which looked at how patient-centered people felt their healthcare had been.
In addition to these scales, the survey gathered information on:
Perceived discrimination
Life satisfaction
A1C levels
Episodes of hypoglycemia
Impact of excess weight
Frequency of healthcare visits
Sources of diabetes education and support
As well as detailed demographic and clinical information, such as age, gender, ethnicity, education, income, treatment types, and duration of diabetes.
The result? A powerful snapshot of what it means to live with diabetes in Canada today, one that highlights not just medical challenges, but social and emotional ones too.
What They Found: The Heavy Toll of Stigma
The results of the survey are hard to ignore: stigma is not just an occasional or isolated experience for people with diabetes in Canada, it’s widespread, and for many, it’s deeply damaging.
Across the country, 92% of adults with Type 1 diabetes (T1D) and 68.2% of those with Type 2 diabetes (T2D) reported experiencing some form of stigma related to their condition. Even more concerning, 34.2% of people with T1D and 13.9% of people with T2D said they had faced outright discrimination. These numbers paint a clear picture, most Canadians living with diabetes, especially those with T1D, are navigating a social world where they often feel judged, excluded, or misunderstood.
Digging deeper into the data, the researchers used the DSAS-1 and DSAS-2 scales to explore the different ways stigma shows up in people’s lives.
Blame and Judgment
One of the most common, and harmful, forms of stigma was the assumption that people with diabetes were somehow responsible for their condition. About 72.5% of T1D respondents said others believed they were less capable because of their diabetes, while 68.6% felt judged for what they ate. For those with T2D, 40.7% experienced stigma rooted in the belief that Type 2 diabetes is just a “lifestyle disease,” and 31.1% reported being judged for their dietary choices.
Being Treated Differently
More than half, 54.1%, of people with T1D said they had been rejected or excluded because of their diabetes. Many also described being treated as “less than” or facing discrimination in the workplace. Among those with T2D, 20% felt they were perceived as "sick" or unable to perform regular duties, and around 10% said they had experienced social exclusion.
Identity and Self-Worth
Stigma doesn’t just come from the outside, it often seeps in and affects how people view themselves. Among individuals with T1D, 44.2% said they worried about injecting insulin in public, and 42.8% felt embarrassed about experiencing low blood sugar. For people with T2D, the internal toll was also significant: 32.5% reported self-blame, 27.4% felt embarrassed about their condition, and 20.1% said they felt guilty just for having diabetes.
Clearly, stigma affects more than social interactions, it deeply impacts emotional and psychological well-being.
How Stigma Affects Mental and Emotional Health
The study also explored how stigma influences broader mental health and quality of life, and the results were troubling.
Diabetes Distress: People who experienced stigma, whether from blame, judgment, or being treated differently, were more likely to report higher levels of diabetes-related emotional distress.
Emotional Well-Being: Higher levels of stigma were linked to lower overall emotional well-being, especially among those who felt judged or blamed.
Quality of Life: Stigma had a noticeable impact on day-to-day life, from work and relationships to social situations and self-care.
Life Satisfaction: Among people with T2D, feeling stigmatized, particularly through internalized self-stigma or being treated differently, was associated with lower life satisfaction. Interestingly, among those with T1D, higher levels of blame and judgment were paradoxically linked with higher life satisfaction. Researchers suggest this might reflect resilience or strong coping strategies in this group.
There was one somewhat hopeful finding: stigma didn’t seem to consistently affect people’s experiences with their healthcare teams. In fact, for people with T2D, being treated differently in society was positively associated with feeling supported in clinical settings, suggesting that healthcare providers may be serving as a safe, empathetic space amid broader social challenges.
Why This Matters - And What Needs to Change
The findings from this study don’t just add to our understanding of diabetes stigma, they make a strong case for urgent action across healthcare, public health, policy, and research.
For healthcare providers, empathy and awareness are absolutely essential. It’s not enough to focus solely on blood sugar levels or medication adherence, clinicians also need to recognize the emotional and social weight that stigma adds to the day-to-day management of diabetes. By incorporating routine screening for stigma during clinical visits, providers can help validate patients’ experiences and offer timely support, fostering trust and improving overall care.
Public health campaigns also have a vital role to play. There’s a clear and urgent need for broader education efforts that challenge harmful myths, especially the persistent stereotype that Type 2 diabetes is simply the result of poor lifestyle choices. These campaigns should focus on promoting compassion, understanding, and accurate information about both Type 1 and Type 2 diabetes, helping to reduce blame and social judgment.
When it comes to policy, this research offers strong support for the development of anti-discrimination protections. People living with diabetes deserve equitable treatment in all areas of life, including the workplace, schools, and public spaces. National-level policies that promote inclusivity and protect against discrimination must be a priority to ensure that people with chronic conditions like diabetes can fully participate in society without stigma or fear.
Finally, the study highlights important directions for future research. Long-term studies are needed to understand how stigma changes over time and how it impacts physical and mental health outcomes. It's also crucial that future research efforts reach beyond online surveys and include the voices of communities that are often underrepresented, such as rural populations, Indigenous Peoples, and those living with lower incomes, to ensure a truly inclusive understanding of diabetes stigma in Canada.
A Call to Action: Time for a Paradigm Shift
This groundbreaking study offers a sobering reminder: living with diabetes in Canada isn’t just a medical journey; it’s a social one, too.
The findings are clear: stigma is real, it is widespread, and it deeply affects emotional well-being, quality of life, and how individuals view themselves and their futures.
Now more than ever, we need a paradigm shift:
From judgment to empathy.
From blame to understanding.
From silence to advocacy.
It’s time for all of us, healthcare providers, policymakers, educators, employers, and the public, to recognize the heavy, invisible burden that stigma adds to the lives of people with diabetes.
The first step? Listening. Learning. And standing in solidarity with the 1 in 3 Canadians who live with diabetes every day, not just in managing their health, but in reclaiming their dignity.
Because no one should feel like a square peg in a round hole simply for living with diabetes.
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