Type 2 diabetes stigma and its association with clinical, psychological, and behavioral outcomes: A systematic review and meta-analysis

S Akyirem, E Ekpor, DN Abwoye, J Batten… - Diabetes Research and …, 2023 - Elsevier
Diabetes Research and Clinical Practice, 2023Elsevier
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 …
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, I2 = 70%, N = 7 studies), a moderate positive correlation between T2D stigma and depressive symptoms (r = 0.49, 95% CI: 0.44 to 0.54, I2 = 26.9%, n = 5 studies) and diabetes distress (r = 0.54, 95% CI: 0.35 to 0.72, I2 = 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, I2 = 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.
Elsevier
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