Social Treatment to Diabetes: What improvements should be performed in order to combat discrimination and alleviate diabetes distress?

This article was exclusively written for The European Sting by Ms. Alifya Rafifah Tarwandi, a third-year medical student in Andalas University in Padang, Indonesia. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Diabetes affects an estimated 537 million persons worldwide between the ages of 20 and 79 (10.5% of all adults in this age range). 643 million by 2030, and 783 million by 2045. It is anticipated that adults between the ages of 20 and 79 will have diabetes. As a result, while the global population is predicted to grow by 20% during this time, the number of people with diabetes is predicted to rise by 46%¹.

Diabetes distress (DD) is the term for the emotional distress brought on by continuing fears, burdens, and concerns that develop over time as a result of managing a demanding chronic illness like diabetes². According to research conducted in the community, type 2 diabetes mellitus patients may experience DD in up to 45% of cases. The prevalence of DD is higher in younger individuals and insulin users. According to other data, 39% of Type 1 patients and 35% of Type 2 patients, respectively, currently experience substantial DD³.

People with diabetes often experience being discriminated. We often hear “Don’t eat too many sweets, you may have diabetes”. This statement is not entirely true yet we’re familiar with this statement in our daily lives. The negative behavior towards them comes from misconception that people with diabetes make unhealthy lifestyle choices and diet that lead to their diagnosis. There are stigmas surrounding people with diabetes type 1 and type 2. Socially identifiable characteristics associated with diabetes may include insulin injection, blood sugar measurement, dietary restrictions, obesity, hypoglycemic episodes, all of them can add to the experience the stigma of diabetes⁴. These stigmas result in diabetes distress. 

What can be done to stop discrimination and alleviate diabetes distress? There are several ways, first is to raise the public awareness about diabetes. This can be done by increasing the public knowledge about etiology, types, and management of diabetes, such as how distinct types of diabetes require different treatments ⁴. 

In order to combat prejudice against persons with diabetes and reduce the prevalence of diabetes distress, public health plays a critical role. The primary goal of the public health strategy is prevention, which also includes education. Giving the public the proper information will increase their knowledge about diabetes, which will help to lessen stigmatization and discrimination towards those who have the diabetes. 

Other suggestions are raising public awareness about diabetes mellitus by the use of social media, creating campaigns to stop the stigma, creating school programs in hope that young generations are aware about diabetes, and revising policies.

In order to alleviate diabetes distress, building a diabetes community in which they can interact with similar peers can also be helpful. Health facilities are also expected to be accessible for those with diabetes. Lastly, it is crucial to have caring healthcare professionals for diabetes care.

References

1.     Webber S. International Diabetes Federation. Vol. 102, Diabetes Research and Clinical Practice. 2013. 147–148 p. 

2.     Fisher L, Hessler D, Polonsky W, Strycker L, Masharani U, Peters A. Diabetes distress in adults with type 1 diabetes: Prevalence, incidence and change over time. J Diabetes Complications. 2016;30(6):1123–8. 

3.     Mascott C. Diabetes distress. Diabetes Self Manag. 2014;31(5):68–70. 

4.     Liu NF, Brown AS, Younge MF, Guzman SJ, Close KL, Wood R. Stigma in people with type 1 or type 2 diabetes. Clin Diabetes. 2017;35(1):27–34. 

About the author

Alifya Rafifah Tarwandi is a third-year medical student in Andalas University in Padang, Indonesia. She is a member of Center for Indonesian Medical Students’ Activities (CIMSA), an affiliated NMO of International Federation of Medical Students Association (IFMSA). Formerly served as Treasurer of Local Standing Committee on Research Exchange CIMSA Andalas University. She has interests in public health, noncommunicable disease, and doing research. She has been participating in several volunteering projects in the aim of playing a role in improving the nation’s health.